"Health & Medical News"

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.

Read the rest of this entry »

Popularity: unranked [?]

An agreement that was struck between a health plan and regulators in New York won’t stop insurers’ use of physician rankings, but it might make them more acceptable to doctors.

Cigna and New York Attorney General Andrew Cuomo’s office on Oct. 29 struck an agreement that requires the insurer to submit to the state the rating criteria it plans to use to place doctors in tiered networks, in which members pay a lower co-pay or otherwise get discounts for seeing favored physicians. Cigna is one of many health plans that have received letters from Cuomo’s office stating that its physician-rankings plan might be misleading to consumers because, in part, it appeared to focus on cost more than quality.

Read the rest of this entry »

Popularity: unranked [?]