A relatively small provision in the stimulus bill that would devote about $1 billion in government research funds to figure out which drugs and medical devices work better than others has some industry groups, conservative talk-show hosts, and others crying "rationing."
To proponents, the research would improve quality of care and reduce health costs by limiting the use of drugs and treatments that do not work well.
Woodland Hills, CA, insurer Health Net has agreed to pay as much as $14 million to settle a pair of lawsuits brought on behalf of 800 former policyholders whose coverage was dropped after they submitted substantial medical bills. Under the deal, individuals whose health insurance policies were canceled since 2004 are eligible for payments of up to $218,000. The average payment is expected to be $7,836.
North Texas lawmakers have urged the state to crack down on Evercare, a health insurer that manages care of 78,000 elderly and disabled Medicaid patients. Republican Sens. Jane Nelson of Flower Mound and Chris Harris of Arlington said that fines against Evercare of Texas haven't worked. At a Senate Finance Committee hearing, both senators said that they still field many complaints from Evercare plan members who can't find doctors willing to see them.
New Jersey is asking 224,000 public employees to show proof that their dependents are eligible for healthcare benefits. The state Pensions and Benefits Divisions has estimated the state is spending as much as $185 million for coverage for those who don't qualify, and the audit is trying to determine if children under 23 are married or if marriages or civil unions have been dissolved.
The Connecticut Office of the Healthcare Advocate, an independent agency that advocates for consumers on health coverage issues, is facing elimination under Gov. M. Jodi Rell's proposed budget. Rell's administration has said the cut was part of an effort to reduce the size of government and that other agencies also monitor health insurance.
Health insurer Aetna Inc. announced its profit fell 57% in the fourth quarter as healthcare costs increased, and the company sustained large capital losses. Aetna earned $194.7 million, or 42 cents per share, down from $448.4 million, or 87 cents per share. The Hartford, CT-based company spent 81.8% of its premium revenue on medical care in the quarter, compared to 80.3% a year ago.