PacifiCare 'Rescission' Settlement Gives Lip Service to Patient Losses But Stacks...

PacifiCare 'Rescission' Settlement Gives Lip Service to Patient Losses But
Stacks Legal Deck in Favor of Insurers

"Reform" Legislation Given Green Light by Insurers

SANTA MONICA, Calif., June 19 /PRNewswire-USNewswire/ -- A settlement
announced today by California health regulators acknowledged that patients
should be able to recover unpaid medical bills following illegal cancellations
of their health coverage. Yet the details of the settlement stack the legal
deck in favor of health insurers, said Consumer Watchdog, allowing them in
many cases to evade any payment.

Under the settlement, insurers could use closed-door arbitration proceedings,
where patients would likely not be able to afford legal representation, to
avoid paying the medical bills racked up by patients both before and after the
policy rescission.

"Instead of weak regulatory capitulations to insurance companies we need
criminal prosecutions of insurance executives whose companies boost profits by
putting a patient's health at risk," said Jerry Flanagan, Health Care Policy
Director for Consumer Watchdog. "Today's announcement gives lip-service to
giving patients the ability to recover unpaid medical bills and other damages
caused by illegal policy cancellations like the loss of a home, but foists an
unfair burden on patients to prove that that care was necessary."

Consumer Watchdog said that health insurers and health plans are pushing
regulators and the state legislature for "reforms" that favor them in legal
proceedings.

"Regulators are saying the right words," said Flanagan, "but they're giving
insurers the fine-print exceptions that they seek, and making it easier for
the companies to evade their clear legal obligations to patients whose
coverage was illegally canceled. In fact, under the settlement, as with those
previously announced for Kaiser and Health Net, patients must act as their own
attorneys in closed door arbitration proceedings where insurers can overwhelm
them with a cadre of their lawyers."

Patients would have to interpret and even try to make complex legal arguments,
said Consumer Watchdog. The patients would also be fighting the insurer about
the necessity of their medical care in front of arbitration judges with
financial ties to the health insurers, not before doctors or medical experts.

A bill before the state Legislature, AB 1945 by Assemblyman Hector De La
Torre, would also allow private companies to decide if policy cancellations
are warranted, even though such companies operate under financial incentives
that favor health insurers. Yesterday, all health insurers and health plans
removed their opposition to the bill following industry-friendly amendments
and the Senate Health Committee approved the measure.

Consumer Watchdog has urged members of the Senate Judiciary Committee to
oppose the measure when it is voted on next Tuesday.

http://www.ConsumerWatchdog.org

SOURCE Consumer Watchdog

Jerry Flanagan of Consumer Watchdog, +1-310-392-0522 ext. 319