And speaking of reprehensible...

[unixronin]

An investigative piece from Reuters discusses how health insurer Wellpoint, the largest umbrella health insurer in the United States, specifically targeted breast cancer victims and used any pretext, however flimsy, to cancel their insurance — and when it couldn't find a plausible excuse, it just made something up.  Despite lawsuits charging illegal rescission of as many as 10,000 Anthem Blue Cross policyholders in California alone (two of which it has so far lost, paying $11 million in fines and $14 million in restitution), Wellpoint maintains it did nothing wrong.  Wellpoint operates Blue Cross/Blue Shield programs nationwide, as well as other subsidiaries.

As reported in another article last month, Assurant Health, another carrier, similarly targeted HIV-positive policyholders for rescission.  Assurant, like Wellpoint, used computer algorithms that automatically initiated a fraud investigation against any subscriber diagnised with HIV.

The investigation last year by the House Energy and Commerce Committee determined that WellPoint and two of the nation's other largest insurance companies -- UnitedHealth Group Inc and Assurant Health, part of Assurant Inc -- made at least $300 million by improperly rescinding more than 19,000 policyholders over one five-year period.

WellPoint itself profited by more than $128 million from the practice, and the committee suggested that the figure might be largely understated because the company refused to provide information about cancellations by several subsidiaries.

And from the second article,

The committee estimated that Assurant alone profited by more than $150 million between 2003 and 2007 from rescission.

When investigated by Congress, Wellpoint hid behind HIPAA as an excuse for refusal to provide information about patients.  Assurant took various measures to cover its tracks, including destroying records and hiding the identities of persons who sat on rescission star-chambers.

One of the [few, IMHO] things the health care bill gets right is to ban the practice of rescission.  What seems still in doubt is whether, once the actual regulations implementing the bill are written, they will have enough teeth to actually stop it.

Comments

[randwolf.livejournal.com]

Discussion (http://www.ianwelsh.net/recissions-and-denial-of-care-under-obamacare) of the law relating to recission under the "Patient Protection and Affordable Care Act," by commentator Ian Welsh, with citation of original text. Ian thinks it looks pretty good, though it does depend on the state insurance commissions and of course the insurance companies can still try to drag out compliance.

[unixronin.livejournal.com]

Yeah. I'm crossing my fingers for that to be effective. It's a despicable practice. Talk about kicking people while they're down.

[house-pundit.livejournal.com]

Can you say, "Class Action Lawsuit"? I knew you could.

[unixronin.livejournal.com]

If these scum can figure out how to hide behind HIPAA to avoid providing information to Congressional investigations, I'm pretty sure they can figure out how to use it to avoid providing any usable evidence in a class-action lawsuit too. That good old Law of Unintended Consequences strikes again...

[lwj2.livejournal.com]

I don't believe HIPAA can be used to avoid a subpoena, if Congress can't figure out how to word one properly, they they need to be turned out.

Moreover, if the body that is responsible for the legislation isn't a "competent jurisdiction" then we're really screwed.

Because I'm a petty person, it's probably a good thing I wasn't the lead attorney for the committee, because I'd be handing over a bunchaton of names to the IRS and SEC for audit.