Tuesday, April 27, 2010

Why health care law is needed: WellPoint: dropping breast cancer patients

U.S. to WellPoint: Stop dropping breast cancer patients
Fri Apr 23, 2010
Reuters

U.S. Department of Health and Human Services Secretary Kathleen Sebelius has called on health insurer WellPoint to stop dropping coverage for patients recently diagnosed with breast cancer, calling the practice "deplorable."

In a letter dated April 22 to Angela Braly, WellPoint's chief executive, Sebelius said she was "surprised and disappointed" to learn from a Reuters report that the company had targeted women with breast cancer for aggressive investigation with intent to cancel their policies.

"As you know, the practice described in this article will soon be illegal," Sebelius wrote. "The Affordable Care Act specifically prohibits insurance companies from rescinding policies, except in cases of fraud or intentional misrepresentation of material fact."

Reuters reported on Thursday that WellPoint, the largest U.S. health insurer by enrollment, was using a computer algorithm that automatically targeted patients recently diagnosed with breast cancer, among other conditions.

The software triggered an immediate fraud investigation by the company as it searched for excuses to drop coverage, according to government regulators and investigators...

2 comments:

Tony said...

According to the market-research group Datamonitor, medical inflation is the reason for yearly increases of 8% in health insurance premiums. The steady progress in the development of new drugs, therapies and equipment used to diagnose medical conditions and the resulting costs are an obvious reason for this. This is understandable and everyone wants the latest in diagnostics and treatments. Equipment becomes obsolete with time and invariably the very words newer and improved mean a rise in cost.

Maura Larkins said...

Unfortunately, the health insurance companies don't want to pay for everybody to benefit from "new drugs, therapies and equipment used to diagnose medical conditions." So they don't. You know very well, Tony, that they limit treatment options, and regularly disallow new treatments. Also, not everyone needs new treatments. Most people just need a decent doctor to take care of them. Why is that too much to ask?