Poizner Calls for Probe Into Anthem’s Claims Payment, Data Systems
On Wednesday, California Insurance Commissioner Steve Poizner (R) announced that his department willÂ investigate the claims payment and information systems Anthem Blue Cross of California used toÂ calculate rate increases, the Sacramento Bee reports (Calvan, Sacramento Bee, 5/6).
Anthem is preparing a revised rate filing after withdrawing plans to increase premiums by as much as 39% for an estimated 800,000 individual policyholders in California.
On Wednesday, the Department of Insurance released the full 145-page independent audit of Anthem conducted by Axene Health Partners. It found errors in the methodology the insurer used to calculate rate increases. However, insurance department officials said the audit did not fully examine the claims payments systems (Colliver, San Francisco Chronicle, 5/6).
Poizner said in a statement, "I will not allow insurers to inflate their rates based on faulty systems or inaccurate data."
Feinstein Calls for Congressional Hearings
Meanwhile, U.S. Sen. Dianne Feinstein (D-Calif.) on Wednesday called for congressional hearings to examine the calculation errors uncovered in the Anthem audit.
Feinstein said, "The revelation that WellPoint/Anthem used flawed data to justify its proposed premium rate hikes ... merits further investigation," adding, "I am skeptical that these errors were completely accidental" (Helfand, Los Angeles Times, 5/6).
WellPoint CEO Addresses Complaints
WellPoint CEO Angela Braly on Wednesday addressed complaints about how the insurer calculates its health insurance premium increases by calling for the implementation of third-party reviews of its 2010 rate filings, according to a company memo sent to employees, the Wall Street Journal reports.
In a memo, Braly said that WellPoint will look into why its own actuaries did not find the miscalculations and that it will change its internal peer review process. Braly also wrote that she is instructing presidents of WellPoint's state plans to contact state regulators and answer any questions they have about company filings.
In addition, Braly pledged to work more closely with the California Department of Insurance and its outside actuary, Axene Health Partners (Johnson, Wall Street Journal, 5/6).
On Wednesday, KQED's "California Report" reported on California officials' audit of Anthem's claims payment and information systems (Varney, "California Report," KQED, 5/5).
The bill would "ensure that people in all states have access to a rate review process that protects them from unfair increases," according to the editorial.
It concludes, "Trusting voluntary action by insurers is not a solution. No matter what profits the insurance companies make, they will never be enough" (Fresno Bee, 5/5).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.