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Making recission illiegal has been tried at the state level. It has failed.

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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-25-10 05:27 AM
Original message
Making recission illiegal has been tried at the state level. It has failed.
Great--they can bust small companies, the very ones that are most likely to go under because of risk pools that are so small they shouldn't be allowed anyway. The big boys are untouchable.

http://cbs5.com/business/anthem.blue.cross.2.763636.htm...

California regulators admitted Thursday that for more than a year they didn't even try to enforce a million-dollar fine against health insurer Anthem Blue Cross because it feared they would be outgunned in court.

In early 2007, the Department of Managed Health Care pledged to fine the state's largest insurer for "routinely rescinding health insurance policies in violation of state law." But they never did.

The department's director, Cindy Ehnes, told The Associated Press on Thursday that, when it comes to rescissions, the agency has had success in forcing smaller insurers to reinstate illegally canceled policies and pay fines, but Blue Cross is too powerful to take on.

"In each and every one of those rescissions, (Blue Cross has) the right to contest each, and that could tie us up in court forever," Ehnes said of the approximately 1,770 Blue Cross rescissions between Jan. 1, 2004, and now.

"They have the largest number of rescissions, so as a practical matter for the department it does present some practical challenges that are different from a Health Net (of California) or a PacifiCare," referring to providers who, along with Kaiser Permanente, have made settlements with the state to reinstate health care coverage.

That means that although Anthem Blue Cross has the highest number of alleged illegal rescissions, it may face the least regulatory consequence simply because of its sheer size, and aggressive legal defense.
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Phoebe Loosinhouse Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-25-10 05:32 AM
Response to Original message
1. So the enforcement arm of the people just rolls over?
MAKE them spend their ill-gotten swag on legal fees, damn it!!Do it enough and they'll get the message. Also, put out press releases about it. If people start to read all that bad stuff, employers will not choose to use them and other consumers will stay away if they have a choice.
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-25-10 05:41 AM
Response to Reply #1
3. Yes. They roll over because they will have given $900 fucking BILLION--
--of our tax dollars to the very people who will ignore the law, leaving almost nothing left over to pay for actually enforcing it.
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depakid Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-25-10 05:36 AM
Response to Original message
2. And this is who the administration and Senate Dems chose to associate the party with
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Juche Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-25-10 05:42 AM
Response to Original message
4. Whats the point of even having insurance
If they are just going to cancel it once you try to use it, why bother?
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-25-10 05:46 AM
Response to Reply #4
6. It's worse than that. with deductibles and copays--
--you have to drain your bank account first before you even see a dime of so-called "insurance."
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uponit7771 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-25-10 05:45 AM
Response to Original message
5. How could they defend somethingt that's illegal? That is a weak ass'd excuse not to act....
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-25-10 05:48 AM
Response to Reply #5
7. If they don't have enough money to pay their lawyers compared to the
--insurance companies, what do you expect will happen?
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depakid Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-25-10 05:55 AM
Response to Reply #7
8. Actually, they don't have enough lawyers
Edited on Mon Jan-25-10 06:11 AM by depakid
They'd have to contract out (which would be even more expensive).

As anyone who understands these deals knows, the big insurers will paper every attorney to death in every case if that suits their overall strategy- and they have the deep pockets to do it.

And now, the Senate Dems (to be fair- only the few Senate extortionists who've been empowered) want to send even more mountains of cash to those parasites, who add nothing of value- and who rather than "produce health" -spend an inordinate amount of money to deny it to people in need.

Without any effective accountability methods- not even a reasonable incentive to the plaintiff's bar to do after these abusive entities with the tort of bad faith.

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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-25-10 06:09 AM
Response to Reply #8
9. Good point. CA is in quite enought trouble financially as it is n/t
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Phoebe Loosinhouse Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-25-10 06:12 AM
Response to Reply #8
10. Can we tell California that if they cannot afford an attorney, the court will appoint one on their
Edited on Mon Jan-25-10 06:17 AM by Phoebe Loosinhouse
behalf?

We need a group like the Peace Corps made up of retired attorneys to fight for the public pro bono in cases like this.

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depakid Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-25-10 09:16 AM
Response to Reply #10
12. Give citizens back the right to sue in tort- which was taken away from them 20 years ago
through through ERISA preemption and other actions, and you'd have all the lawyers that you'd need.

If insurers can't abuse folks with impunity- they'll think twice before playing games with rescission or denying care.

A few fat jury verdicts would take care of that....
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Winterblues Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-25-10 10:24 AM
Response to Reply #8
15. As long as the loser has to pay the other sides legal fees the state should not hesitate.
Edited on Mon Jan-25-10 10:24 AM by Winterblues
If the state can not recoup their expenses then we no longer have a democratic Government. It is now officially fascism. Corporations dictate how it will be and the government meekly acquiesces.
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depakid Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-25-10 03:55 PM
Response to Reply #15
16. Oh yeah, that's a beauty- make patients pay even more in the event the insurance company prevails
Edited on Mon Jan-25-10 03:55 PM by depakid
That'll help with medical bankruptcies and provide a real deterrent for abusive behavior.

:eyes:

Bad faith rescission and claims denials are actions undertaken by the insurance corporations to avoid paying for care. It's not something that the patient initiates.

Rather shows the folly of relying on them at all as the basis for medical reimbursement.
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PA Democrat Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-25-10 09:34 AM
Response to Reply #7
14. It's the same reason the IRS doesn't go after some of the biggest tax cheats.
These people can afford to tie up the government's lawyers for YEARS.
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Gregorian Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-25-10 08:16 AM
Response to Original message
11. Too big to fail? It's more like too big to be held accountable.
We're in a battle. Against the Senate, the military, the big corporations run by greedy owners.
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PA Democrat Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-25-10 09:18 AM
Response to Original message
13. Even after a $10 million award for punitive damages, Assurant Health still practices rescission.
Edited on Mon Jan-25-10 09:20 AM by PA Democrat
The South Carolina Supreme Court has unanimously awarded $10 million in punitive damages to a young man living with HIV whose coverage was retroactively rescinded by his health insurer after he filed his first HIV-related claim. The September 14 ruling, calling the insurance companys behavior in the matter reprehensible, also affirmed an award of $150,000 in actual damages for bad faith breach of contract. Mitchell v. Fortis Insurance Company, Opinion No. 26718, 2009 Westlaw 2948558 (South Carolina Supreme Ct., September 14, 2009).


Jerome Mitchell, Jr., was an apparently healthy 17-year-old on May 15, 2001, when he applied to the Fortis Insurance Company for an individual health insurance policy because his mothers health insurance would no longer cover him, as he was going off to college in the fall. Mitchell truthfully completed the application form, indicating that he had never been diagnosed as having or been treated for any immune deficiency disorder. His application for insurance was approved.


Almost a year later, in April 2002, Mitchell participated in a Red Cross blood drive, and on May 13, 2002, received the unfortunate news that his blood donation had tested HIV-positive. Red Cross advised him to have this confirmed by his own doctor. Mitchell went to Dr. Michael Chandler the next day, when he was tested and the positive result was confirmed. Dr. Chandlers assistant wrote a note that was attached to his chart: Gave blood in March got letter yesterday stating blood tested HIV. This handwritten note correctly identified Mitchell as 18 years old, but mistakenly recorded the date of the appointment with Dr. Chandler as May 14, 2001, rather than 2002.

http://newyorklawschool.typepad.com/leonardlink/2009/09...

Read the rest of the story at the link. Based upon that one error made by the doctor in which he hand wrote the wrong date, the young man's insurance was rescinded. This despite the fact that there was a mountain of other irrefutable evidence proving the date the doctor wrote was a clerical error.

The company now goes by the name of Assurant Health but they are still the same filthy crooks who cheated this young man out of health care they contractually agreed to provide. Connecticut's Attorney General Blumenthal recently went after them for the same fraudulent practices.

http://www.ct.gov/ag/cwp/view.asp?A=2341&Q=333840

Apparently, it is still more profitable to deny and delay as many legitimate claims as possible.


Edited to clarify name of company.
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-26-10 06:33 PM
Response to Reply #13
17. Thanks for that link--it's going to my congressman's aide n/t
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amborin Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-26-10 06:34 PM
Response to Original message
18. glad you posted this! it needs LOTS of exposure! K&R
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