FROM THE FOUNDATION

November Conference on Better Chronic Disease Care

Emerging trends and effective models in chronic disease care will be shared at a November 6-7 networking conference in San Francisco. CME credits are available. Register now to ensure your seat.

Leveraging Excellence, Advancing Practice Award

The LEAP Award recognizes the spread of model practices and innovative ideas to address the growing needs of the state's underserved populations. Five organizations will each receive $25,000 for their efforts.

Health Care Costs

Tuesday, July 08, 2008

WellPoint Agrees To Pay $11.8M to Hospitals in Rescissions Case

On Monday, WellPoint agreed to pay $11.8 million to about 480 hospitals statewide after refusing to pay for the bills of patients whose health policies its Anthem Blue Cross unit rescinded after patients received treatment, the Indianapolis Star reports (Indianapolis Star, 7/8).

The hospitals sued the insurer in 2006 after patients alleged that Anthem Blue Cross had improperly investigated their medical histories after claims were submitted. In many cases the health plan claimed to find preexisting conditions that it cited as cause for rescinding the policies.

As part of the settlement, the hospitals agreed to stop attempting to collect the outstanding balance on the disputed bills from patients (Girion, Los Angeles Times, 7/8).

Daron Tooch, an attorney for the hospitals, said patients will be compensated for all out-of-pocket costs that they paid for their treatments (Gullo, Bloomberg News/Houston Chronicle, 7/7).

The settlement is pending final approval from Los Angeles County Superior Court Judge Peter Lichtman.

Other Actions

Anthem Blue Cross faces a similar class-action lawsuit from physicians, as well as a class-action lawsuit filed on behalf of more than 6,000 patients whose coverage the insurer has rescinded since 2001.

The insurer also faces potential regulatory action from the state (Los Angeles Times, 7/8).



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