Many insurers are adding more doctors and hospitals for plans sold on health insurance exchanges. But they insist the provider expansion isn't a result of public outrage and pushback against narrow networks.
Some insurers' narrow networks include a mismatch among providers where in-network doctors don't have privileges at any of the in-network hospitals.
Blue Shield of California won't pay for reconstructive surgeries to return disfigured patients to normal appearances, which violates state law, a lawsuit against the insurer claims.
WellPoint and other California insurers have donated $13.4 million toward defeating a ballot initiative that would authorize California regulators to reject increases in premiums, Bloomberg reported.
insurers are dealing with their own technical and administrative problems. Plus, they're facing an increasingly frustrated public complaining that insurers can't confirm coverage, aren't providing adequate customer service, and haven't issued identification numbers needed to cover medical services.
A trio of California insurers--Anthem Blue Cross, Health Net and Blue Shield--received orders Monday to cease and desist from denying benefit payment for speech and/or occupational therapy services, according to an announcement by the state's Department of Managed Health Care.
Amid reports of cancellation letters sent to members because plans don't meet healthcare reform's essential health benefits, lawmakers and state officials are pressuring insurers to allow members to retain their policies.
The fallout of actual and looming health insurance policy cancellations is clear in California, where two people are suing Anthem Blue Cross over the issue and Blue Shield of California agreed to delay cancellations for 130,000 customers until March 31.
Insurers have clearly demonstrated their belief that narrow network plans will help them soften the impact of rising costs associated with new members under the reform law. But could the increased use of narrow networks also be a strategy to help avoid enrolling consumers with expensive, pre-existing conditions?
Insurers have been reviving narrow networks for plans they're going to sell through the health insurance exchanges, believing consumers will trade provider choice and access for lower premiums.