Southern California Physician - http://www.socalphys.com/article
Attorney's Office Demands That Blue Cross Back Up Claims
http://www.socalphys.com/article/articles/725/1/Attorneys-Office-Demands-That-Blue-Cross-Back-Up-Claims/Page1.html
By Chris Womack
Published on 04/1/2008
 
Chris Womack

 

As part of its investigation into the health insurance industry's rescission practices, the Los Angeles City Attorney's office requested that Blue Cross substantiate claims in a press release that it had improved its rescission policies.


The Los Angeles City Attorney requests that Blue Cross substantiate its press release on rescission.

The story of Blue Cross of California's effort to gather data that might be used to rescind patient insurance coverage continues. As part of its investigation into the health insurance industry's rescission practices, the Los Angeles City Attorney's office requested that Blue Cross substantiate claims in a press release that it had improved its rescission policies.

Blue Cross weathered a hail of unflattering media attention for asking doctors for information that might be used to rescind coverage. In response, the company issued a press release, which caught the City Attorney's attention by claiming that in 2006 it had "implement[ed] a series of steps to strengthen and make more transparent our process for rescinding policies in order to further minimize the possibility of errors." The company also claimed to have recently begun a rescission review process.

Writing that it is authorized to prosecute violations of the Unfair Competition Law and the False Advertising Law, the Office of the City Attorney sent Blue Cross a Request for Advertising Claim Substantiation, requesting information on the health plan's claims within 21 days. "California State law says the failure to adequately respond to this type of request within a reasonable time authorizes the City Attorney to presume that the advertising claim is false or misleading, to disseminate information alerting consumers to the false or misleading nature of the advertising claim and/ or to seek appropriate judicial relief," explains Nick Velasquez, a spokesperson for the City Attorney's office.

In responding to the City Attorney, Blue Cross asserted its message had been truthful. "We are following all business practices that were described in a recent press statement, indeed, most have been shared with the public in the past, and have been in place for well over a year," the company said. "In addition, as described in the recent statement, we are actively in the development of a third party review process for use on all potential rescissions."