I wanted to stay away from this story but as it has evolved, I can't resist it anymore. First there were the very serious charges that Wellpoint specifically targeted women with breast cancer (who were also very costly for them to continue to insure) for thorough audits to look for excuses to cancel their policies. These charges got reinforced by healthcare heavyweights like HHS Secretary Kathleen Sebelius. Then there were the adamant denials by Wellpoint that the charges were completely unfounded. At that point I didn't know who to believe and felt it was best not to comment until more came out.
Now comes the announcement from Wellpoint that even though they did nothing wrong they are changing how they proceed on this going forward. So now I am confused. This sounds a lot like the little boy accused of taking cookies from the cookie jar who says, "No I didn't do it but I won't do it again". At least whatever practices were or weren't happening will now stop.
The practice of rescission by healthcare providers has gone on for years and has been the ugliest form of cost shifting that happens all over the place in the current payment patchwork that we have in place. Thank goodness payment reform is here. It is certainly needed. Addressing issues like rescission and denials for pre-existing conditions is long overdue. I'm not thrilled with all aspects of the new healthcare reform bill but I am certainly happy to see these issues addressed.
More on this later.
Mark Brodeur
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