Tag Archives: Medical Issues

California Regulators Are Urged To Scrutinize Health Insurance Mega-Mergers

by Chad Terhune, Los Angeles Times

Stethoscope on money

There’s a lot at stake for families and employers if the deals go through and leave three health insurers in control of nearly half of the U.S. commercial insurance market. … Much of the debate centers on whether insurers should be required to limit rate increases for a time, expand their provider networks and make other pledges to improve patient care in order to win regulatory approval at the state level. … Consumer advocates say they fear that existing problems over affordability and access to care will get worse as insurers consolidate market power. Read More ›

Supreme Court Rejects Class-Action Suit Against DirecTV

by Robert Barnes, Washington Post

“These decisions have predictably resulted in the deprivation of consumers’ rights to seek redress for losses, and turning the coin, they have insulated powerful economic interests from liability for violations of consumer protection laws,” wrote [dissenting Justice Ruth Bader] Ginsburg. … “It has become routine, in a large part due to this court’s decisions, for powerful economic enterprises to write into their form contracts with consumers and employees no class-action arbitration clauses … further degrading the rights of consumers and further insulating already powerful economic entities.” Read More ›

Nonprofit Blue Shield Accused Of Backing Out Of $140-Million Charity Pledge

by Chad Terhune, Los Angeles Times

Blue Shield’s corporate conduct has come under intense scrutiny for the past year after officials revoked its longtime state tax exemption. Auditors at the California Franchise Tax Board criticized the insurer for stockpiling “extraordinarily high surpluses” of $4 billion and for failing to offer more affordable coverage as a nonprofit. California Insurance Commissioner Dave Jones is also investigating Blue Shield’s disclosures on executive compensation. Read More ›

Beware The Fine Print: Arbitration Everywhere, Stacking The Deck Of Justice

by Jessica Silver-Greenberg and Robert Gebeloff, The New York Times

The move to block class actions was engineered by a Wall Street-led coalition of credit card companies and retailers, according to interviews with coalition members and court records. Strategizing from law offices on Park Avenue and in Washington, members of the group came up with a plan to insulate themselves from the costly lawsuits. Their work culminated in two Supreme Court rulings, in 2011 and 2013, that enshrined the use of class-action bans in contracts. The decisions … upended decades of jurisprudence. Read More ›

Utilities Spend Lots Of Public’s Money To Influence State Politics

by Teri Sforza, The Orange County Register

“Your No. 1 example, PG&E, is textbook!” [said Chapman University political science professor Mark Chapin Johnson.] “They answer to the state through the PUC, not their shareholders. … Whenever PG&E wishes to contribute vast sums of ratepayers’ monthly payments to the political process, all PG&E needs do is gain permission to raise rates with the PUC to cover such contributions. Public shareholders or ratepayers have no say in the process. Is this a great system or what? Talk about incestuous!” Read More ›

Consumers Can Check Medical Prices, Quality Scores On New State Website

by Chad Terhune, Los Angeles Times

stethescope and computer keyboard

California and 44 other states received a failing grade in an annual report card that measures how much access patients have to actual prices for medical care. The new online tool seeks to remedy that. … Consumers could use the website to check whether the price they were quoted for a routine lab test or procedure is out of line with the average cost in their community. Armed with that information, a patient could shop around or negotiate for a lower fee. … Researchers said the data also show a wide variation on the quality of care that patients receive from different providers.
Read More ›

Who Else Has Accessed Your Medical Data?

by Lisa Zamosky, Los Angeles Times

So far in 2015 alone, there have been more than 32 health data breaches as a result of hacking, according to the U.S. Health and Human Services Office for Civil Rights. “Health records are more valuable to identity thieves than financial records, and they can actually be sold at a premium on the black market,” [says one expert]. … It’s a more complicated crime to resolve than financial theft, with fewer protections in place to help patients whose information is stolen. … Medical identity theft can also dangerously cause someone else’s health data to get intertwined with yours. Read More ›

Bigger May Be Better For Health Insurers, But Doubts Remain For Consumers

by Reed Abelson, New York Times

Anthem, which operates for-profit Blue Cross plans in 14 states, merging with Cigna, another large for-profit carrier, along with the planned deal for Aetna to join Humana, a smaller rival known for its private Medicare plans, would create two behemoths.
Along with the already enormous UnitedHealth Group, these companies would control nearly half of the American commercial health insurance market. … “Are these companies not big enough that they needed to be bigger?” [asked one insurance broker]. “They’re all huge.” Read More ›

Anthem To Buy Cigna, Creating Biggest U.S. Health Insurer

by Ankur Banerjee and Ransdell Pierson, Reuters

Anthem Inc said on Friday it would buy Cigna Corp for about $54.2 billion, creating the largest U.S. health insurer by membership and accelerating the industry’s consolidation from five national players to three. … State insurance regulators and federal antitrust authorities are expected to scrutinize how the Anthem-Cigna and Aetna-Humana deals would affect competition for Medicare and individual and commercial insurance. Within a few hours of the announcement, several U.S. lawmakers and a leading physicians group said they feared the pending acquisitions would hurt consumers … Read More ›

Aetna’s 21% Rate Hike Amounts To ‘Price Gouging,’ California Regulator Says

by Chad Terhune, Los Angeles Times

Pregnant woman worrying over bills

“Aetna’s pattern of unreasonable increases equates to price gouging in today’s market,” [said Shelley Rouillard, director of the California Department of Managed Health Care.] … Overall, the managed-care agency has found six rate increases unreasonable since 2011, and four of them were from Aetna. In May, the regulator found Aetna’s 19.2% increase for small employers unreasonable. But California officials have no power to stop health insurance rate increases. Read More ›

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