Blue Cross — California’s largest for-profit health plan — plans to lower the payments “for about half the services and procedures provided by physicians next month.”
Blue Cross says “The insurer does not intend to pay physicians’ less than their costs, but determining what those costs are is difficult.”
Docs say that “In most cases, they say, Blue Cross will get its way because it controls the lion’s share of their patient base,” although some plan to drop Blue Cross altogether — or have patients pay for the difference between their prices and Blue Cross’ payments.
This detrimental cost-cutting effort on Blue Cross’ part’s one of the many charges against Blue Cross that’re up for public hearing — along with unfairly revoked health insurance policies, violations of fair claims handling laws, and retroactive cancellation of sick patients — happening August 7, 2007.
If you’re a Blue Cross member like me, you might be interested in checking out the Sick of Blue Cross group that’s acting as a watchdog of sorts over the company.
In addition, Kaiser Permanente — California’s largest HMO — is getting rebuked and slapped with a record fine: $3 million, or $2 if Kaiser “makes necessary improvements,” by The California Department of Managed Health Care. Basically, Kaiser only haphazardly investigated member complaints and concerns about questionable care.
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