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CA Blue plans will pay $13M in fines over cancellations

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Anthem Blue Cross And Blue Shield

Two of the state of California's largest health plans have agreed to pay a combined total of $13 million in fines related to their practice of rescinding policies for members after those members became sick. The fines are the largest yet imposed by the state Department of Managed Health Care, which has been focused of late on stopping health plans from reviewing patient applications and canceling policies after the patient begins incurring large medical bills. In addition to the fines, the agreements will require the two plans, Anthem Blue Cross and Blue Shield, to offer new coverage to more than 2,200 beneficiaries. However, the two are not admitting any wrongdoing.

WellPoint-owned Blue Cross will pay a record $10 million fine, and will offer no-strings-attached coverage to 1,770 members whose policies were canceled since 2004. Competitor Blue Shield, meanwhile, will pay $43 million and offer new policies to 450 people whose policies were discontinued during the same period. Both health plans have agreed to set up a process to help ex-members recover medical bills paid out of pocket after they were dropped, as well as collect other damages, such as reimbursement for homes or business lost because unpaid medical bills ruined the patients' credit. The agreements follow on similar settlements with Kaiser Permanente, Health Net and PacifiCare.

To learn more about the agreements:
- read this Los Angeles Times piece

Related Articles:
WellPoint pays hospitals $11.8M to settle bills from rescissions
BC of California fined $1M for cancellations
Kaiser forced to reinstate coverage
Blue Cross of CA settles plan-cancellation suits

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Imagine if IBM had dropped employees from health care coverage for incurring large medical bills. Would have been front page news.

Insurance companies and the supposed "not for profit" hospital industry continue to push the envelope for outrageous behavior, and yet seem curiously insulated from public outrage. Is it because these more local companies scare off investigation and reporting by newspapers fearful of advertising losses.

Don't worry, they will be back with even more outrageous demands, because until a tipping point is reached and the absolute arrogance of the hospital-insurance industry complex is exposed, it has every reason to continue the abuses. Why?

Because it pays off.

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