Costs Are Lower, Quality Is Higher When Insurers Compete For Consumers: HHS Secretary Burwell
Elsewhere, insurance companies and employers are facing off with out-of-network providers in Texas courts in multiple lawsuits over charges and payments. Meanwhile, California Healthline looks at the class-action suit filed against Blue Shield of California.
Top U.S. Health Official Highlights Need For Insurer Competition
Health and Human Services Secretary Sylvia Mathews Burwell said competition among insurers can reduce costs that consumers face and improve the quality of their health coverage. She declined to comment on her department’s view of Aetna Inc.’s proposed purchase of Humana Inc. or Anthem Inc.’s deal for Cigna Corp. If both mergers are completed, the industry’s five largest companies would be reduced to three. (Tracer, 7/15)
Fancy Amenities Woo Patients While Insurers Cry Foul
With specialty medical services growing quickly here, Houston has become the legal battleground for an increasingly bitter fight between insurers and employers, on one side, and out-of-network providers on the other. At least a dozen lawsuits over provider charges and insurance payments have been filed in U.S. District Court in Houston, with one national insurer accusing a local hospital of racketeering, fraud and paying kickbacks to doctors for referrals. (Sixel, 7/15)
Did Blue Shield Of California Short-Change Consumers On Refunds?
A class-action lawsuit filed earlier this month claims that Blue Shield of California stiffed consumers on more than $34 million dollars in refunds on premiums they paid in 2014. Federal law requires insurers to issue refunds if they don’t spend at least 80 percent of premium dollars on medical care or on improving the quality of care. The lawsuit, filed July 1 in Los Angeles County Superior Court, argues that Blue Shield improperly counted as medical expenses certain payments it had made erroneously in 2014 — to providers who were not in its network and patients whose coverage had lapsed. (Bartolone, 7/18)