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-- require an exhaustive review of the rescinded patient's actions,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:12/17/2014)... -- Expectant parents should leave prenatal picture-taking to medical ... Use of ultrasound imaging and heartbeat monitors to get ... agency warns. "Although there is a lack ... and heartbeat monitors, prudent use of these devices by ... FDA biomedical engineer, said in an agency news release. ...
(Date:12/17/2014)... HealthDay Reporter , TUESDAY, Dec. 16, ... America, and work commitment is a big reason why, new ... said Dr. Mathias Basner, an assistant professor of sleep and ... of Medicine. A time-use survey of nearly 125,000 Americans, ... main activity exchanged for sleep. Short sleepers -- those who ...
(Date:12/15/2014)... 15, 2014 South Florida’s leading urgent care ... can be a daze of hassle, hustle, and bustle that ... decking halls, to burns when making special meals and heartburn ... can happen at any time. To prevent this season of ... made a list of helpful and healthful holiday tips to ...
(Date:12/15/2014)... News) -- Expert pilots process visual information more efficiently ... better decisions during landings, a new study shows. ... pilots to master, and 36 percent of all airplane ... final approach and landing. Researchers monitored the brain ... pilots while they were at the controls of a ...
(Date:12/15/2014)... 15, 2014 At the leading, long-established ... AutismOne and Focus Autism will welcome ... research on the effects of toxins to children’s health, ... information. , Luminaries such as Dr. Lucija Tomljenovic ... with esteemed, credentialed colleagues of the United States to ...
Breaking Medicine News(10 mins):Health News:FDA Warns Against Fetal 'Keepsake' Videos 2Health News:Work Steals Valuable Sleep Time, Study Finds 2Health News:Work Steals Valuable Sleep Time, Study Finds 3Health News:MD Now Urgent Care Presents Healthy Holiday Tips 2Health News:MD Now Urgent Care Presents Healthy Holiday Tips 3Health News:Study Shows Why Expert Pilots Are Experts 2Health News:AutismOne and Focus Autism Collaborate on Scientific Conference; International Group of Researchers to Present in Chicago, May 2015 2Health News:AutismOne and Focus Autism Collaborate on Scientific Conference; International Group of Researchers to Present in Chicago, May 2015 3
... Pre-Emption in Riegel v. Medtronic, Inc., WASHINGTON, Oct. ... Medical Technology Association,(AdvaMed) filed a joint amicus brief Friday ... v. Medtronic, Inc. arguing that the FDA should,continue to ... states that,no other legislative or regulatory entity is better ...
... of the National Association for Home Care & Hospice ... of caring, both at home,and in their local communities, ... "It is highly appropriate that we take a ... aides and other providers who have chosen,to use their ...
... is proud to be participating in a Global Theme ... the Council of Science Editors. , The CSE global ... and debate on the crucial matters of poverty and ... and developing countries will simultaneously publish papers on this ...
... , , MONDAY, Oct. 22 (HealthDay News) -- If you,re sneaking ... a common device can determine whether someone is a smoker. ... to ferret out people who hide a cigarette habit, ... patients what smoking is doing to their bodies, he added. ...
... 2007 Late-breaking results from the ENDEAVOR IV trial, ... the Cardiovascular Research Foundation, show that the Endeavor zotarolimus-eluting ... overall safety profile (equivalent rates of death, heart attack, ... 1 year. , In addition, the Endeavor stent ...
... Bayer Consumer Care announces,the availability of the newly-named ... combining a long-lasting nasal decongestant with the,pain-relieving power ... sinus and pain symptoms. The combination of ... a recent survey of adults who suffer from ...
Cached Medicine News:Health News:Amicus Brief Filed with U.S. Supreme Court in Riegel v. Medtronic, Inc. 2Health News:U.S. Celebrates National Home Care and Hospice Month in November 2Health News:9 SAGE journals participate in global theme issue on poverty and human development 2Health News:Blood Test Catches Secret Smokers 2Health News:Blood Test Catches Secret Smokers 3Health News:ENDEAVOR IV achieves primary endpoint, demonstrates similar safety profile compared to Taxus stent 2Health News:ALEVE-D(R) Sinus & Cold Offers Option for the More Than 50% of Consumers Not Satisfied with Current Sinus Medication 2Health News:ALEVE-D(R) Sinus & Cold Offers Option for the More Than 50% of Consumers Not Satisfied with Current Sinus Medication 3
(Date:12/17/2014)... 2014 Los beneficios y ganancias ... nivel de gasto en investigación y desarrollo   ... 30 de septiembre de 2014) ZEISS aumentó sus ingresos ... euros (año anterior: 4.190 millones de euros) a pesar ... (EBIT) crecieron un 14 por ciento, a 360 millones ...
(Date:12/17/2014)... With advancements in neurological and functional ... seeing new growth, according to Kalorama Information. Though ... the majority of market volume, newer 3T systems ... are creating opportunities for more sophisticated applications. The medical ... a rate of 4%, with world market revenues ...
(Date:12/17/2014)... 17, 2014  IGI Laboratories, Inc. (NYSE MKT: IG; ... its offering of $125 million aggregate principal amount of ... Notes were offered and sold only to qualified institutional ... of 1933, as amended (the "Securities Act"). ... 3.75% per year, payable semiannually in arrears on June ...
Breaking Medicine Technology:ZEISS confirma su posición en un entorno difícil 2Kalorama: 3T Advancements Bringing New Growth to the MRI Market 2Kalorama: 3T Advancements Bringing New Growth to the MRI Market 3IGI Laboratories Announces Closing of $125 Million of 3.75% Convertible Senior Notes Due 2019 2IGI Laboratories Announces Closing of $125 Million of 3.75% Convertible Senior Notes Due 2019 3IGI Laboratories Announces Closing of $125 Million of 3.75% Convertible Senior Notes Due 2019 4
... (NASDAQ: UNIS / ASX: UNS) ("Unilife" or ... public offering of 8,250,000 shares of common stock at a ... shares in the offering are to be sold by Unilife. ... underwriters a 30-day option to purchase up to an additional ...
... Nov. 16, 2011 HASCO Medical, Inc. (OTCBB: HASC), ... patients in Alabama, Florida, and Mississippi, announced its third ... Net income was $91,447 for the three months ... of ($426,373) for the three months ended September 30, ...
Cached Medicine Technology:Unilife Corporation Announces Pricing of Offering of 8,250,000 Shares of Common Stock 2Unilife Corporation Announces Pricing of Offering of 8,250,000 Shares of Common Stock 3HASCO Medical Announces Third Quarter 2011 Financial Results 2HASCO Medical Announces Third Quarter 2011 Financial Results 3HASCO Medical Announces Third Quarter 2011 Financial Results 4
VisiClaim allows you to create, submit, track and manage your claims and reimbursements. VisiClaim gives you control over managing your claims and your billing....
The HearTwave system is the original stand-alone Microvolt T-Wave Alternans (MTWA) testing platform....
... 3 mirror lenses featuring ultra-clear Volk 3-Mirror ... 76°, 66° and 60°. The 3 ... well central and peripheral fundus viewing and ... angled to eliminate gaps in the visualized ...
... The Chalam 45° Prism are ... and are recommended for tractional ... and Rhegmatogenus retinal detachment. They ... photocoagulation and other midperipheral laser ...
Medicine Products: