CHICAGO, April 22, (Reuters) - U.S. Department of of Health and Human Services Secretary Kathleen Sebelius signaled the government will continue take a aggressive approach toward insurers who unlawfully deny healthcare coverage.
Sebelius, speaking to a group of health journalists in Chicago on Thursday, said to expect “hand-to-hand combat” if insurers try to “drive patients out of plans.”
She cited a Reuters report that said WellPoint WLP.N, the largest health plan in the Blue Cross Blue Shield Association, was using a computer algorithm that automatically targeted women suffering from breast cancer and every other policyholder recently diagnosed with breast cancer.
The software triggered an immediate fraud investigation, as the company searched for some pretext to drop their policies, according to government regulators and investigators. [ID:nN20207082]
Once the women were singled out the insurer then canceled their policies based on either erroneous or flimsy information. WellPoint declined to comment on the women’s specific cases without a signed waiver from them, citing privacy laws.
“That is reprehensible if that is true,” said Sebelius. “We will reach out to those companies.”
She noted a similar situation in which Assurant Health had dropped HIV AIDS patients from its plans.
She has in the past faced off with insurance company chief executives, asking them to explain significant hikes in premiums.
She said her agency has been working closely with state governors and insurance commissioners to roll out various pieces of health care reform.
Asked about the likelihood that all or part of the bill would be repealed in years to come, Sebelius said that will depend upon how well reform is implemented, whether citizens feel it is helping them and whether misinformation about it can be dispelled.
Getting the “early deliverables” rolled out effectively will be a critical component to the public buying into the benefits of healthcare reform, she said.
Government funds dedicated to prevention and wellness, such as the focus on smoking and obesity, will pay dividends longer term.
Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, said that after years of steady declines in the nation’s smoking rates, progress has stalled over the last few years and that the agency was renewing its focus.
He said government stimulus funds would be used to increase anti-smoking efforts. He said the CDC would encourage states to implement anti-smoking strategies, such as education and media campaigns, smoke-free laws and higher cigarette prices.
According to the CDC’s latest state-by-state assessment, Utah and California have the nation’s lowest smoking rates at 9.3 percent and 14 percent, respectively. West Virginia and Indiana have the highest rates at 26.5 percent and 26 percent.
Smoking, he said, is still the leading preventable cause of death.
(Editing by Bernard Orr)
Reporting by Debra Sherman, 312 408 8134
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