Sometimes, it makes sense for the pot to call the kettle black. No stranger to accusations of unfair policy cancellations, Kaiser Foundation Health Plan has begun working with state officials to establish stricter--and fairer--rules under which individual health plans to be canceled. Kaiser itself was recently fined $100,000 by California regulators after dropping a policyholder it accused of concealing his epilepsy; it had canceled the member despite the fact that his condition had never been diagnosed by a doctor.
Kaiser is now proposing that health plans consult with policyholders before canceling coverage, to determine better whether the policyholder intentionally mislead them. Kaiser's proposed regulatory changes would help to appease scores of consumers, who have filed dozens of lawsuits alleging that that many such sight-unseen cancellations violate state law. While the proposal puts Kaiser in synch with consumer health advocates, it goes head-to-head with rival health plans. Blue Cross of California, for example, continues to fight for the right to rescind coverage when relevant medical information is left out, even if the patient makes an honest mistake or misunderstands a health question.
I've gotta tell you, folks… I'm not sure where Kaiser is going with this one. It'd be one thing if Kaiser was trying to become Mr. Nice Guy as a result of regulators breathing down their neck (well, breathing more than with other carriers). But why Kaiser would invest so much executive energy bucking its competitors on this isn't clear to me. Is this a consumer marketing ploy? A planned massive initiative focused on individual customers If you have a better sense of this than I do I'd love to hear it.
To get more background on Kaiser's proposals:
- read this article from the Los Angeles Times
PLUS: The California Medical Association has asked patients to join it in a class-action suit, one which accuses Blue cross of dumping policyholders after authorizing high-priced medical treatment. Article