CMA Seeks To Join Suit Against Blue Cross of California
The California Medical Association on Dec. 26, 2006, asked to join a class-action lawsuit alleging that Blue Cross of California inappropriately cancelled individual health insurance policies and declined to pay for previously authorized treatment, the Los Angeles Times reports. CMA represents more than 30,000 physicians in California.
CMA alleges that the cancellations are illegal and routine, according to the Times. CMA maintains that state law requires insurers to reimburse health care providers for preauthorized care, regardless of whether the insurance coverage subsequently is revoked.
CMA maintains that insurers' cancellation of individual insurance policies contributes to some state residents' seeking coverage under Medi-Cal.
WellPoint, the parent company of Blue Cross, declined to comment on CMA's action.
The California Hospital Association earlier in December 2006 petitioned to join its own class-action lawsuit with a lawsuit that patients have filed against Blue Cross.
Patients have brought two lawsuits that seek class-action status against Blue Cross.
The Department of Managed Health Care is drafting a rule intended to clarify a state law governing policies for canceling individual health insurance coverage.
DMHC Director Cindy Ehnes in December 2006 announced that the department would convene its first public hearing on the proposed rule on Jan. 29 (Girion, Los Angeles Times, 12/27/06).
California this year is expected to spend more than $10 billion on individuals who are unable to obtain health insurance from private insurers because of chronic illnesses or pre-existing medical conditions, the Los Angeles Times reports.
Through the state's high-risk insurance pool, private insurers administer coverage to about 7,800 individuals. The majority of enrollees have been rejected for individual coverage by at least one private insurer, according to the Times.
Monthly premiums for the plan can cost up to one-third of an individual's income, and, in most cases, the premium fee is higher than an enrollee's medical expenses, the Times reports (Girion, Los Angeles Times, 12/31/06).