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Time for a
rant.
Although I (and
many others) have long been critics of Wall Street's incredibly sleazy,
recklessly psychopathic, and relentlessly self-destructive underbelly, there
is another corner of the financial services industry that seems to have made
reprehensible behavior a cornerstone of its business model.
As the New York Times reports in, "Insurers
Alter Cost Formula, and Patients Pay More," the
insurance industry seems intent on making Congress look like a bastion of
honesty and ethical behavior.
Despite a
landmark settlement that was expected to increase coverage for out-of-network
care, the nation’s largest health insurers have been switching to a new
payment method that in most cases significantly increases the cost to the
patient.
The settlement,
reached in 2009, followed New York State’s accusation that the
companies manipulated data they used to price such care, shortchanging the
nation’s patients by hundreds of millions of dollars.
The agreement
required the companies to finance an objective database of doctors’
fees that patients and insurers nationally could rely on. Gov. Andrew M.
Cuomo, then the attorney general, said it would increase reimbursements by as
much as 28 percent.
It has not
turned out that way. Though the settlement required the companies to
underwrite the new database with $95 million, it did not obligate them to use
it. So by the time the database was finally up and running last year, the
same companies, across the country, were rapidly shifting to another
calculation method, based on Medicare rates, that usually reduces
reimbursement substantially.
“It’s
deplorable,” said Chad Glaser, a sales manager for a seafood company
near Buffalo, who learned that he was facing hundreds of dollars more in
out-of-pocket costs for his son’s checkups with a specialist who had
performed a lifesaving liver transplant. “I could get balance-billed
hundreds of thousands of dollars, and I have no protection.”
That's not the
end of it, of course. In fact, all it takes is about 10 minutes of Googling to come up with plenty of other stories about an
industry that apparently feels really good about doing bad:
"MetLife
Settles Suit Over Missed Beneficiary Payments"
"Insurers
Probed by New York Over Force-Placed Coverage"
"Hartford
in $24 Mln NY Insurance Settlement"
"Will
Farmers Insurance Settlement Turn into a Good Deal For Customers?"
"A Class
Action Lawsuit Alleges Wells Fargo Partnered With Insurers To Rip Off
Homeowners"
"ANALYSIS:
Health Insurers Try To Fool Congress With Fuzzy Math"
"Adjusters:
Insurance Companies Preventing Policy Payouts"
"Insurance
Company Ordered to Pay $34 Million For Kicking 90-Year-Old Arlene Hull Off
Plan"
"As
Weather Gets Biblical, Insurers Go Missing"
"Insurance
Company Sued By Sewage Plant Owners: Binghamton, Johnson City Say Company
Improperly Withheld Payment"
"Aetna
Rate Hike Is Deemed 'Excessive' By California Regulator"
"Maryland
Law Would Ban Insurers From Requiring Consumers ‘Bundle’"
"Class
Action Lawsuit Filed Against Citizens Property Insurance Corp."
"MetLife
Must Defend Lawsuit Over Retained Asset Checkbook"
Michael J. Panzner
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