Monday, October 23, 2006

Blue Cross Blue Shield Named in Class Action Suit in California

Blue Cross of California is being sued by hospitals in the state over its rescission policies. The law firm of Hooper, Lundy & Bookman, Inc. said it filed a class-action complaint on behalf of the California's hospitals in Los Angeles County Superior Court on Oct. 13. The firm said the suit seeks to expand protection of hospitals statewide from California Blue Cross' practice of "retroactively rescinding insurance policy coverage for numerous patients after the health care services have been provided by the hospitals." The class-action complaint follows California Department of Managed Health Care's $200,000 fine against the WellPoint, Inc. affiliate for improperly rescinding coverage of one patient. The suit asserts that the rescissions directly impact the hospitals, because they are not being paid for their services, and instead are being directed by the health plan to collect from the patients. WellPoint spokesperson Shannon Troughton declined to comment on the lawsuit, explaining that "we have still not been served with a copy of the complaint, and haven't been able to review it." She added that "our payment practices are in compliance with applicable California law." In a related development, Blue Cross of California is in settlement discussions with certain former members whose individual policies had been rescinded. Troughton said the insurer is in confidential mediation with former members regarding their canceled policies. According to the Los Angeles Times, the insurer agreed to settle more than 70 lawsuits and claims by members whose coverage had been rescinded.

I found this in my AIS newsletter today. I find it interesting how health insurers are increasingly named in suits like this one. Essentially these insurers are saying, lets charge these increasingly skyrocketing premiums and oh, oops, you people who are sick in the hospital are costing us WAY too much money, so we're just NOT GOING TO PAY those claims. Sorry. Why do Americans continue to pay these exorbitant amounts of money to insurers? It is MIND BOGGLING to me! Do they think that their rate of rise of premiums is sustainable?? Do they think tat the American parents will continue to pay so much money for an in network doctor to be in charge of their child's health?? The declining reimbursement has pressured providers to hire nurses to do all the patient care for them anyway, in an environment of antiquated systems and non existent customer service. Why not hire a Personal Pediatrics affiliate Pediatrician to care for your child carefully, thoughtfully and in a way that's convenient for your family and lifestyle, at home. Why not utilize a company for your healthcare that provides password protected access to your child's medical record?? Why should your doctor have such control of your child's medical record such that you have to beg for access with long waits and multiple phone calls?? Take a look at www.personal and watch our story as it unfolds. A new wave of healthcare is coming, right to your house. For more about our affiliate pediatricians in your neighborhood, visit the website! Natalie Hodge MD St. Louis Personal Pediatrics Affiliate Pediatrician.

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