Wellpoint has been busted again. And this new savage attack against sick women must not go unpunished.
Wellpoint singles out women with breast cancer for aggressive investigation with the intent of canceling their insurance federal investigators told Murray Waas at Reuters.
Despite the passage of the Patient Protection and Affordable Care Act, the shameless for-profit insurance industry, which remains at the heart of our new and improved health care system, is digging in to fight sick Americans at every bend in the road.
The latest atrocity is a just released report via Reuters, that Wellpoint routinely and systematically targeted breast cancer patients and rescinded their policies once they became ill.
One after another, shortly after a diagnosis of breast cancer, each of the women learned that her health insurance had been canceled. First there was Yenny Hsu, who lived and worked in Los Angeles. Later, Robin Beaton, a registered nurse from Texas. And then, most recently, there was Patricia Relling, a successful art gallery owner and interior designer from Louisville, Kentucky
It gets worse.
Before I go any further, keep in mind, Wellpoint has more customers than any other U.S. health insurance company. And it should be clear to everyone that the thugs who run this company have every intention of gaming the new law at every opportunity. They reward their executives very well for their predatory business practices.
The CEO of Wellpoint Angela Braly 2009 compensation package skyrocketed 51 percent from 2008 to $13.1 million.
Wellpoint already busted for gaming medical loss ratios.
Wellpoint got busted out of the box for gaming the medical loss ratio requirements the new law mandates.
Now Wellpoint is busted for targeting breast cancer patients.
Now, Wellpoint is busted for routinely and savagely canceling the policies of women with breast cancer. This is chilling, and certainly fills me with fear about what these predatory companies will think of next, to stay one step ahead of the law.
When will the elected class begin to include jail as the only remedy for the executives like Angela Braly of Wellpoint, who endorse these illegal activities?
None of the women knew about the others. But besides their similar narratives, they had something else in common: Their health insurance carriers were subsidiaries of WellPoint, which has 33.7 million policyholders -- more than any other health insurance company in the United States.
The women all paid their premiums on time. Before they fell ill, none had any problems with their insurance. Initially, they believed their policies had been canceled by mistake.
They had no idea that WellPoint was using a computer algorithm that automatically targeted them 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.
Once the women were singled out, they say, 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.
The New legislation lacks teeth and must be improved.
Many critics worry the new law will not lead to an end of these practices. Some state and federal regulators -- as well as investigators, congressional staffers and academic experts -- say the health care legislation lacks teeth, at least in terms of enforcement or regulatory powers to either stop or even substantially reduce rescission.
Patient Protection and Affordable Care Act lobbied to death.
Tragically, the Patient Protection and Affordable Care Act, was lobbied to death, and at this point, without new laws and enforceable regulations, many believe it lacks the teeth to effectively end these egregious insurer atrocities.
. . .During the recent legislative process for the reform law, however, lobbyists for WellPoint and other top insurance companies successfully fought proposed provisions of the legislation. In particular, they complained about rules that would have made it more difficult for the companies to fairly -- or unfairly -- cancel policyholders.
For example, an early version of the health care bill passed by the House of Representatives would have created a Federal Office of Health Insurance Oversight to monitor and regulate insurance practices like rescission. WellPoint lobbyists pressed for the proposed agency to not be included in the final bill signed into law by the president.
They also helped quash proposed provisions that would have required a third party review of its or any other insurance company's decision to cancel a customer's policy.
What insurers hate the most: Breast cancer and pregnancy.
INSURERS' ANATHEMA: BREAST CANCER AND PREGNANCY
The cancellation of her health insurance in June 2008 forced Robin Beaton to delay cancer surgery by five months. In that time, the tumor in her breast grew from 2 centimeters to 7 centimeters.
Two months before Beaton's policy was dropped, Patricia Relling also was diagnosed with breast cancer. Anthem Blue Cross of Kentucky, a WellPoint subsidiary, paid the bills for a double mastectomy and reconstructive surgery.
But the following January, after Relling suffered a life-threatening staph infection requiring two emergency surgeries in three days, Anthem balked and refused to pay more. They soon canceled her insurance entirely.
Unable to afford additional necessary surgeries for nearly 16 months, Relling ended up severely disabled and largely confined to her home. As a result of her crushing medical bills, the once well-to-do businesswoman is now dependent on food stamps.
The fight for sweeping and strong regulations of the insurance industry continues.
This is why slinkerwink, I and others have urged everyone to respond to the HHS call for comments on how this predatory industry must be regulated. Though, thus far, HHS has asked for comments only on medical loss ratios, and premium price gouging.
Regulating this industry won't be easy.
Jeff Isaacs is a former federal prosecutor.
Isaacs is a former federal prosecutor who spent much of his time with the U.S. Justice Department investigating corporate wrongdoing. Among state and federal regulators, he is now considered one of the toughest and most experienced foes of the health insurance industry. He has hired retired FBI agents to investigate full-time the practices of WellPoint and its Anthem Blue Cross subsidiary in California.
Still, Isaacs feels outgunned: "The industry just has these tremendous financial, legal and political resources that others don't," he said. "In my own state, regulators are often afraid or unwilling to go up against them. It is hard to figure out what the future brings."
. . .As part of his investigation, Isaacs has sought information from WellPoint about its use of algorithms to single out women with breast cancer or who are pregnant. The company has fought him vigorously and so far largely kept information from him, Isaacs said.
As I've told you, slinkerwink and I are very close to launching a web site which we believe will help Americans fight this murderous industry.
We welcome and thank you for your support in fighting insurer atrocities.
The funds donated to the Progressive Congress Action Fund, a 501(C)4 not for profit, will be used to advocate on behalf of the progressive agenda, to advance progressive legislation, and may include payments to individuals engaged in fund raising.