Criticism Prompts Blue Cross To End Application Review Requests
Faced with mounting criticism, Blue Cross of California on Tuesday said it would stop sending doctors letters asking them to report pre-existing medical conditions that could be used to rescind patients' health care coverage, the Sacramento Bee reports (Griffith, Sacramento Bee, 2/13).
Blue Cross made the announcement after the Los Angeles Times reported Tuesday that the insurer was sending physicians copies of new patients' health insurance applications along with a letter advising them to immediately report any "condition not listed on the application that is discovered to be pre-existing" (California Healthline, 2/12).
In the letter, Blue Cross also maintains the right to rescind members' coverage if they fail to fully disclose their medical history, including "pre-existing pregnancies" (Girion/Rau, Los Angeles Times, 2/13).
The California Medical Association asked the Department of Managed Health Care last week to order Blue Cross to stop sending the letters. In its request, CMA said that asking doctors to share patient information with insurers is "deeply disturbing, unlawful and interferes with the physician-patient relationship."
Shannon Troughton -- a spokesperson for WellPoint, Blue Cross's parent company -- maintained that the policy was intended to control health care costs and complied with federal medical privacy rules (California Healthline, 2/12).
Blue Cross said it has sent such letters for several years and has not received any complaints previously (Colliver, San Francisco Chronicle, 2/13).
However, amid growing criticism following the Times report, Blue Cross released a statement saying it "determined this letter is no longer necessary and, in fact, was creating a misimpression and causing some members and providers undue concern" (Sacramento Bee, 2/13).
CMA President Richard Frankenstein said, "We're relieved that Blue Cross is ending this particular tactic but continue to have serious concerns about this company's practices looking forward" (Los Angeles Times, 2/13).
Gov. Arnold Schwarzenegger (R) criticized Blue Cross for trying to get doctors "to rat out their patients." The governor said the incident highlights the need to adopt comprehensive health care reform.
Last month, Senate lawmakers rejected an overhaul plan (ABX1 1) backed by Schwarzenegger. The bill included a provision that would have prohibited insurers from denying coverage to applicants based on age or pre-existing medical conditions.
Blue Cross led industry opposition to the measure (Herdt, Ventura County Star, 2/13).
It is unacceptable "to not disclose an important medical condition when applying for medical insurance," but it is also not "appropriate to ask doctors to violate a sacred trust for the benefit of cost cutting," a Contra Costa Times editorial states. "There simply has to be another way," otherwise "costs shouldn't be cut," according to the editorial.
"Doctor-patient confidentiality is simply too important a concept to be sacrificed at the altar of cost containment" (Contra Costa Times, 2/13).
On Tuesday, KPCC's "Air Talk" included a segment on the Blue Cross letters including comments from David Aizuss, president of the Los Angeles County Medical Association. Aizuss also is affiliated with CMA.
Full audio of the segment is available online.