February 3rd, 2008 Posted by: Dr. Dobson
A California appeals court dealt another blow to health plans over their policy cancellation tactics.
The 4th District Court of Appeal unanimously said insurers have a responsibility to make sure patients’ policy applications are complete and accurate before issuing coverage — not after expensive claims come in the door. Judges said plans cannot revoke patients’ policies unless they fully investigate pre-enrollment forms up front or insurers show patients intentionally misled them.
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December 2nd, 2007 Posted by: Dr. Dobson
Washington — The Dept. of Health and Human Services is appealing a court order that it release Medicare physician claims data to a consumer group.
The HHS appeal in late October blocks for now a plan by Consumers’ Checkbook/Center for the Study of Services to use the claims data to provide patients with more detailed information about the quality of physician care. The nonprofit organization had planned, as a first step, to create a free online public resource listing how many times in one year individual physicians had performed certain Medicare procedures in the District of Columbia and the four states covered by the order: Illinois, Maryland, Virginia and Washington.
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