WellPoint Routinely Targets Breast Cancer Patients

[The Straight Story]

Exclusive: WellPoint Routinely Targets Breast Cancer Patients

LOS ANGELES (Reuters) - One after another, shortly after a diagnosis of breast cancer, each of the women learned that her health insurance had been canceled. First there was Yenny Hsu, who lived and worked in Los Angeles. Later, Robin Beaton, a registered nurse from Texas. And then, most recently, there was Patricia Relling, a successful art gallery owner and interior designer from Louisville, Kentucky.

None of the women knew about the others. But besides their similar narratives, they had something else in common: Their health insurance carriers were subsidiaries of WellPoint, which has 33.7 million policyholders -- more than any other health insurance company in the United States.

The women all paid their premiums on time. Before they fell ill, none had any problems with their insurance. Initially, they believed their policies had been canceled by mistake.

They had no idea that WellPoint was using a computer algorithm that automatically targeted them and every other policyholder recently diagnosed with breast cancer. The software triggered an immediate fraud investigation, as the company searched for some pretext to drop their policies, according to government regulators and investigators.

http://abcnews.go.com/Health/wireStory?id=10446307

[sharp_stick]

1. Rescission is probably the thing I hate most

about these scumbag insurance companies. They're happy as hell taking your cash until you decide to make a claim, then the "investigation" begins.

Whoever thought this little gem up is one of the lowest forms of scum imaginable and yet he probably got a nice fat bonus for saving the industry so much cash.

[amborin]

6. state of CA did not have enough $$$$ or time to sue Anthem Blue Cross for recission

corps can rescind for "fraud" very loosely defined

[Big Blue Marble]

2. In Kentucky, you cannot cancel insurant for a health condition.

Amazingly, we are one of the few states with this protection. So there must be more to the story about the woman from
Kentucky.

[sharp_stick]

3. I don't think that's why they're being canceled..

It's not due to a specific health condition, even though that condition triggered the "audit"... and I use the term "audit" in the loosest possible sense here. They are being canceled through rescission.

Rescission is a practice where the insurance company looks for what they decide to call fraud after the client has been with the company for a period of time. The definition of fraud is usually a scam, something like forgetting to report that you had a boil on your ass lanced 30 years ago. Another favorite is canceling because the client was one or two days late with a payment many months or even years earlier.

One of the funny things about rescission is that insurance companies never bother to look for this fraud during the many years that the client is fully paid up on insurance only after they get an expensive disease like cancer or rheumatoid arthritis.

The scumbag companies also don't bother to return all of the premiums that have been coughed up between the so called fraud date and the date of rescission.

[AuntPatsy]

4. K & R

Naww, no need for health care reform....not this country...

[GCP]

5. It gets worse - from the Huffpost

The version of health care bill passed by the House of Representatives would've allowed these women to apply to an "independent external third party" for review before being dropped. It also would have required Wellpoint to keep their coverage in place until the board made its determination, and policies could only be canceled in cases with "clear and convincing evidence of fraud."

Those provisions were not included in the Senate Finance Committee bill, however, which became the basis for the final health care bill signed by the President. Reuters says that Wellpoint lobbyists "helped quash proposed provisions that would have required a third party review of its or any other insurance company's decision to cancel a customer's policy."

As Marcy Wheeler reported last year, the Senate Finance Committee bill was written by former WellPoint VP Liz Fowler, who left her position at the insurance company in February 2009 expressly for the purpose of helping the committee to draft the health care bill:

And when Max Baucus did a "victory lap" after the health care bil passed, he expressly thanked Fowler for her work:

I wish to single out one person, and that one person is sitting next to me. Her name is Liz Fowler. Liz Fowler is my chief health counsel. Liz Fowler has put my health care team together. Liz Fowler worked for me many years ago, left for the private sector, and then came back when she realized she could be there at the creation of health care reform because she wanted that to be, in a certain sense, her profession lifetime goal. She put together the White Paper last November-2008-the 87-page document which became the basis, the foundation, the blueprint from which almost all health care measures in all bills on both sides of the aisle came. She is an amazing person. She is a lawyer; she is a Ph.D. She is just so decent. She is always smiling, she is always working, always available to help any Senator, any staff. I thank Liz from the bottom of my heart. In many ways, she typifies, she represents all of the people who have worked so hard to make this bill such a great accomplishment.


Susan Bayh, wife of Indiana Senator Evan Bayh, is on the WellPoint board. Bayh threatened to join Joe Lieberman in a filibuster of the health care bill if a public option was included, something that would very much threaten WellPoint profits -- which have soared in the past year. Susan Bayh's compensation for her role on the WellPoint board includes valuable stock options.

Before the health care bill passed, Harry Reid promised Bernie Sanders that there would be a vote on the public option "in the coming months," and anonymous "hill aides" said that they were looking to use the reconciliation process, such that only 50 Senate votes were needed for passage. In exchange, Sanders offered to give up on his plans to offer a public option amendment. A public option would mean that at the very least, breast cancer and AIDS patients who were unfairly dropped from private insurance plans had some place to go for medical coverage.

But the Senate budget committee is marking up next year's budget right now, and according to the Hill, there are no plans to include reconciliation instructions for health care. Which means that for the next year, any plan to "fix it later" would require 60 votes in the Senate -- but the public option doesn't have 60 votes. Which means Reid punk'd Sanders, Jeff Merkley and other progressive Senators to secure their votes.

http://www.huffingtonpost.com/jane-hamsher/wellpoint-lobbyists-axed_b_548220.html

I'm so angry, I could hurl something. We've been sold a bill of goods, by our own side.

[Feron]

7. And now we have to buy insurance from these assholes.

But hey, Democrats got their win. Unfortunately it's the American people who aren't millionaires that will lose.

Why should an insurance company change if they know that there is a captive audience and politicians to bribe?!

[LoZoccolo]

8. Sounds like a corporate death panel to me. n/t

[Bluebear]

9. These women can all reapply for insurance in 2014.

When the pre-existing condition exclusion is supposed to go away.

:silly: