Navigation Links
CA Legislature's 'Reform' of Health Insurance Cancellations Resembles Insurance Industry's Own Plan; Insurers, Satisfied With Getting a Legal Edge Against Patients, Drop Opposition to the Bill
Date:6/23/2008

For a rescission to be rightful, an insurer must prove a patient

misrepresented a health fact that materially affected the insurer's

decision to grant coverage.

-- Even if a third party panel includes laypersons and legal experts, it is

not good policy to have a company -- whether for-profit or nonprofit --

with financial interest in retaining its contract with the state replace

a judge and jury.

-- The "facts" of a rescission review -- whether a patient lied

-- require an exhaustive review of the rescinded patient's actions,

unlike existing third-party medical reviews that consider the

particulars of a diagnosed medical condition and do not require an

interaction with the patient. The two situations cannot be compared.

-- The existing third-party independent medical review has come under

increased scrutiny and criticism for failing to observe the appropriate

statutory requirements when conducting reviews, and the Department has

been lax in its oversight.

-- Insurers may at any time bring pressure to bear on the regulators and

seek termination of a contract if a reviewer too often returns

unfavorable results. In fact, the IMR review process under a company

known as Maximus sides with health plans in 70% of the cases it reviews.

That's why the insurance companies have publicly supported the same

system for rescission.

-- The great majority of rescissions involve the actions of insurance

brokers who often counsel patients about how to fill out the complex

applications of the individual insurance -- recommendations that are

often colored by the insurance agent's financial incentives in

selling coverage. Who would review the agent's action in the

third-party review? Who would judge the weight of that evidence?

-
'/>"/>

SOURCE Consumer Watchdog
Copyright©2008 PR Newswire.
All rights reserved

Page: 1 2 3 4 5

Related medicine news :

1. Assembly on the Move for Rx Reform
2. Bayer Announces Availability of Reformulated Liquid Leukine(R)
3. ACP says major system reforms needed to improve the state of primary care medicine in the US
4. AARP Statement on Governors Bill for Prescription Drug Marketing Reform and Transparency
5. Presidential Candidates Health Care Plans Lack Key Reform Elements, Aspen Institute Finds
6. CEOs From Multiple Health Industries Announce Consensus Plan to Reform U.S. Health Care
7. Aspen Institute to Release Presidential Candidates Responses to Health Care Reform Questionnaire; New Zogby Poll Findings Also to be Released
8. SEIU Retaliates Against California Caregivers & Democratic Reform Movement
9. Photos: New Kind of Health Care Reform Brings Five-Star Hospitality to Hospital Care
10. Voters Believe They Hold Power in Health Care Reform Debate
11. Kidney Care Community Applauds National Taxpayers Unions Endorsement of Medicare Reforms to Extend Patient Private Health Insurance Coverage; Calls Proposal Common Sense Coverage Reform
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/29/2015)... “In the current environment of opiate ... we provide education that will help practitioners address ... from pain, within the boundaries of the guidelines ... rehabilitation medicine and President/Medical Director of the International ... A new flight of PAINWeekEnd Regional Conferences offers ...
(Date:5/29/2015)... Tallahassee, FL (PRWEB) May 29, 2015 Ready ... trip, it’s important for all drivers to get their vehicles ... do to be prepared. Advanced Driving Systems (ADS) is ready ... some tips on preparing for summer road trips. , When ... do the following to ensure that the trip goes smoothly ...
(Date:5/29/2015)... May 29, 2015 The science of ... Los Angeles thanks to the efforts of internationally recognized ... has combined ARTAS hair restoration and manual ... restoration procedures available anywhere. , A Follicular Unit ... individually harvesting hair follicle grafts from the donor areas ...
(Date:5/29/2015)... Rhode Island (PRWEB) May 29, 2015 ... 7, 2015. The event, now closed to new registration, ... Fort Adams. This exciting competitive running event demonstrates ... organizations to create a public benefit – in this ... scenic coastal views around the famed Ocean Drive and ...
(Date:5/29/2015)... Abington Hospital – Jefferson Health has ... in the nation to join the EMPower ... work toward achieving the Baby-Friendly USA© designation. , ... maternity care practices leading to Baby-Friendly designation. Funded ... EMPower is aimed at increasing breastfeeding rates throughout ...
Breaking Medicine News(10 mins):Health News:PAINWeekEnd Kansas City: Pain Management CME for the Main Street Practitioner 2Health News:Advanced Driving Systems Offers Tips for Summer Road Trips 2Health News:Advanced Driving Systems Offers Tips for Summer Road Trips 3Health News:Los Angeles and Beverly Hills Hair Transplant Doctor Now Combines Robotic Hair Restoration (ARTAS) and Manual FUE Transplants for Maximum Hair Coverage 2Health News:The Newport 10 Miler at Fort Adams, an Outstanding Example of Event Marketing Helping in Preservation, is Now Completely Booked for 2015 2Health News:The Newport 10 Miler at Fort Adams, an Outstanding Example of Event Marketing Helping in Preservation, is Now Completely Booked for 2015 3Health News:Abington Hospital Selected to Join Baby-Friendly Hospital Initiative 2
... BEACH, Va., May 30 AMERIGROUP,Corporation (NYSE: AGP ... Sachs Global Healthcare Conference on June 11 at Dana ... which begins Wednesday,June 11 at 5:40 p.m. Eastern Time, ... on the investors, page. A replay of,the webcast will ...
... smoked cigarettes or used other tobacco products for many ... cancer will return, according to research by Dana-Farber Cancer ... of the American Society of Clinical Oncology (ASCO), May ... 965 patients treated for stage III colon cancer, investigators ...
... were more likely than whites to die in a ... blacks for life-extending treatment even in the face of ... researchers at Dana-Farber Cancer Institute in Boston. ,The findings ... of the American Society of Clinical Oncology in Chicago ...
... more than 2,000 years ago by Hippocrates, has finally been ... The phenomenon of "finger clubbing", a deformity of the fingers ... has long been recognized to be a sign of a ... "It,s one of the first things they teach you at ...
... at the American College of Sports Medicine Annual ... zero-calorie, zero sweetener water beverage, developed by researchers ... hydrates as well as a leading sports/electrolyte drink, ... calories, and artificial ingredients many sports beverages offer ...
... rich in fruits and vegetables and low in animal ... to the so-called Mediterranean diet, which is rich in ... protect you against developing type 2 diabetes, a Spanish ... as a way to guard against cardiovascular disease, but ...
Cached Medicine News:Health News:Black patients with terminal cancer more likely to choose aggressive care at end of life 2Health News:Leeds medics solve an ancient riddle -- and offer new tool for diagnosis 2Health News:Zero-calorie Aqua-Lyte hydrates as well as leading sports drink 2Health News:Mediterranean Diet May Ward Off Type 2 Diabetes 2Health News:Mediterranean Diet May Ward Off Type 2 Diabetes 3
(Date:5/29/2015)... and MENLO PARK, Calif. ... Pharmaceuticals, Inc. (OTCQX: DMPI) ("DelMar" and the ... commercializing proven cancer therapies in new orphan drug ... American Association of Cancer Research (AACR) Advances in ... for its lead product candidate VAL-083 ...
(Date:5/29/2015)... 29, 2015 Educating the community continues ... for the Advancement of Wound Care (AAWC), which ... from AAWC,s corporate partners, the Association provides medical ... the AAWC website at http://aawconline.org/education-for-the-generalist/ . The ... with links to various CME/CEU educational programs. This ...
(Date:5/28/2015)... 28, 2015 Research ... addition of Jain PharmaBiotech,s new report  "RNAi ... their offering.       (Logo: http://photos.prnewswire.com/prnh/20130307/600769) ... silencing involves the use of double stranded ... material is processed into short 21-23 nucleotide ...
Breaking Medicine Technology:DelMar Pharmaceuticals Presents Additional Data on the Potential of VAL-083 in the Treatment of Temozolomide-Resistant Glioblastoma Multiforme 2DelMar Pharmaceuticals Presents Additional Data on the Potential of VAL-083 in the Treatment of Temozolomide-Resistant Glioblastoma Multiforme 3DelMar Pharmaceuticals Presents Additional Data on the Potential of VAL-083 in the Treatment of Temozolomide-Resistant Glioblastoma Multiforme 4DelMar Pharmaceuticals Presents Additional Data on the Potential of VAL-083 in the Treatment of Temozolomide-Resistant Glioblastoma Multiforme 5The Association for the Advancement of Wound Care Educates the Public 2Global RNAi Market Report 2015-2024 - Technologies, Markets and Companies 2Global RNAi Market Report 2015-2024 - Technologies, Markets and Companies 3
... ... that a new market research report is available in ... Trends , http://www.reportlinker.com/p0164367/Immunoassay-Instruments---Global-Market-Trends.html , Immunoassay ... years due to the innovation of new technologies and ...
... ... a new market research report is available in its ... Market Analysis , http://www.reportlinker.com/p0164335/Cardiac-Pacemakers---A-World-Market-Analysis.html , ... expanding cardiovascular devices market. The worldwide cardiac pacemakers market ...
Cached Medicine Technology:Reportlinker Adds Immunoassay Instruments - Global Market Trends 2Reportlinker Adds Immunoassay Instruments - Global Market Trends 3Reportlinker Adds Immunoassay Instruments - Global Market Trends 4Reportlinker Adds Immunoassay Instruments - Global Market Trends 5Reportlinker Adds Immunoassay Instruments - Global Market Trends 6Reportlinker Adds Immunoassay Instruments - Global Market Trends 7Reportlinker Adds Cardiac Pacemakers - A World Market Analysis 2Reportlinker Adds Cardiac Pacemakers - A World Market Analysis 3Reportlinker Adds Cardiac Pacemakers - A World Market Analysis 4Reportlinker Adds Cardiac Pacemakers - A World Market Analysis 5Reportlinker Adds Cardiac Pacemakers - A World Market Analysis 6Reportlinker Adds Cardiac Pacemakers - A World Market Analysis 7Reportlinker Adds Cardiac Pacemakers - A World Market Analysis 8Reportlinker Adds Cardiac Pacemakers - A World Market Analysis 9Reportlinker Adds Cardiac Pacemakers - A World Market Analysis 10
... providing excellence in Ambulatory ECG Monitoring ... physicians in the diagnosis and treatment ... each year. State-of-the-art equipment and technology ... highest standard of customer service makes ...
... is an e-health service developed by ... Telemedicine patient monitoring devices. Designed ... monitoring devices, AerotelNet.com improves patient and ... advanced communication capabilities make it easy ...
... The iEMS Incubator/Shaker HT is ... the iEMS Incubator/Shaker HT is ... DNA hybridization and primer extension ... available as a one-cabinet model, ...
The iEMS Incubator/Shaker is a high performance microplate incubator and orbital shaker. Its superior temperature control and efficient orbital shaking reduce incubation times. -...
Medicine Products: