A commentary on insurance coverage issues in Hawaii and beyond
If you have ever sought out of network health care, here is a story to make your blood boil.
Today's New York Times reports that Congressional investigators have discovered a faulty database overcharged patients for seeing doctors outside their insurance plan network. The database was operated by Ingenix, a subsidiary of UnitedHealth Group. The Congressional…
Whether coverage for an allogeneic stem-cell transplant ("allo-transplant") was properly denied by the insurer was at issue in Hawaii Medical Service Association v. Adams, No. 28899 (Haw. Ct. App. May 21, 2009) [here]. An allo-transplant, used to treat myeloma, involves the harvesting and transplanting of stem cells from a matched donor. "Myeloma" is…
The issue before the New York Court of Appeals in Fasso v. Independent Health Assoc., No. 21 (N.Y. Feb. 24, 2009) [here] was whether the injured party and the tortfeasor could settle on terms that extinguished the insurer's subrogation rights?
Plaintiff was treated by Dr. Doerr and subsequently developed complications that…
The Hawaii legislature recently passed HB No. 2224, a bill requiring group health issuers to offer small group health plans to self-employed individuals. The effective date of the bill is September 1, 2008. The bill authorizes the Insurance Commissioner to exempt certain group health plans if the group health issuer does not…
The Honolulu Star Bulletin reports Hawaii Medical Service Association (“HMSA”) will increase its rates for large-employer groups of 100 or more employees by 9.2 percent, the steepest increase since 2002 when the rates were raised 12.9 percent. HMSA, the state’s largest health insurers, says although hospital admissions are not increasing, medical payments to …
