Disgrace of Health Insurance

The irony is that we are the "lucky ones" who have Health Ins. Coverage- This disgrace below speaks volumes of what has become of our totally dysfunctional Health Insurance Plans in America- These cannot be human beings who do things like this to us- Jerry



CALIFORNIA-BASED INSURANCE PLAN FINED $1 MILLION
On November 15, the California Department of Managed Health Care (DMHC) fined Health Net, a California-based insurance company that covers nearly 240,000 people through Medicare Advantage plans, $1 million for linking staff bonuses to terminating coverage for enrollees in its commercial plans.

According to recently released court documents, Health Net compensated Barbara Fowler, a senior analyst, with $20,000 in bonuses for retroactively rescinding individual and family health policies. Between 2000 and 2006, Fowler personally cancelled 1,600 policies, exceeding monthly targets and saving the company $35.5 million in medical expenses.

Although Health Net strove to keep the details of the bonuses confidential to protect “proprietary information,” state documents were released as the result of a recent court case. Patsy Gates, a former Health Net enrollee, is suing the plan for $6 million in compensation and damages after her individual policy was rescinded during post-surgery chemotherapy sessions.

Health Net claimed Gates, who suffers from breast cancer, provided an incorrect weight on her application and did not disclose a heart problem relating to prior use of Fen-Phen, a weight-loss drug linked to heart disease and pulmonary hypertension. Gates claimed that a lackadaisical broker, who performed an interview in the hair salon where she worked, caused her to give incorrect or incomplete information. Health Net's policy termination has left Gates with $200,000 in unpaid medical bills, as well as a catheter in her chest from the interrupted chemotherapy sessions.

The DMHC fine is not the first action taken by the state for inappropriate plan termination. The department recently fined Blue Cross of California $1 million and Kaiser Permanente $325,000 for illegally terminating individual health insurance policies, and it continues to investigate Health Net, as well as three additional companies that offer individual health policies in the state—WellPoint, UnitedHealth, and Blue Shield of California.
Tweet