Bills take aim at deceptive practices

May 1, 2009

Policy makers focus on consumer protection and health plan conduct

NATIONAL REPORTS - Washington policy makers and consumer advocates are throwing the book at health insurers for deceptive practices in setting rates and coverage policies. There's legislation moving through Congress to require disclosure of little-known coverage exclusions; investigations continue into methods for calculating out-of-network costs; and proposals are circulating to prevent insurers from rejecting applications due to pre-existing conditions.

The Senate Commerce Committee is focusing more on consumer protection related to health insurance under its new chairman, Sen. Jay Rockefeller (D-W. Va.).

Rockefeller is sponsoring legislation that would prevent insurers from denying coverage to individuals based on pre-existing conditions. The bill also bans higher premiums for patients with certain diseases, as well as surcharges for higher-cost care.

Separately, the House recently approved legislation requiring insurers to fully disclose all limits on benefit exclusions.

At a Commerce Committee hearing in March, UnitedHealth Group President Steve Hemsley and Ingenix CEO Andy Slavitt were on the hot seat as Rockefeller and his colleagues pressed for an explanation of out-of-network rate-setting practices. He wants to know how the emerging new system will operate and if all major insurers are supporting it.