WellPoint To Ban Coverage Rescissions Before Affordable Care Act Fall 2010 Deadline

WellPoint, Inc. will suspend the practice of rescinding patients’ coverage May 1, 2010, months in advance of this Fall’s deadline for insurers stop this practice established by the Affordable Care Act. The nation’s largest health insurer announced here its plans to implement the change in its practices regarding individual market rescissions on April 27, 2010.  

Beginning this Fall, the Affordable Care Act will prohibit insurance companies from rescinding policies, except in cases of fraud or intentional misrepresentation of material fact. Wellpoint’s termination of individual policy rescissions announced this week comes months ahead of the effective deadline for terminating rescissions contained in the legislation.  The ban against rescissions is one of a number of new federal restrictions on health insurers and group health plans enacted as part of the Affordable Care Act scheduled to take effect this Fall.  Wellpoint previously announced it also would change its dependent coverage policies to extend the period that a dependent child can remain on his parent’s coverage to age 26 before the deadline required by the Affordable Care Act.

WellPoint’s announcement comes after Health & Human Services Secretary Kathleen Sebelius sent a letter on April 22 urging the company to immediately stop the practice of rescinding coverage for patients who become ill.  Wellpoint recently drew criticism from Secretary Sebelius and others for targeting breast cancer victims for rescission of their policies.  Secretary Sebelius’ initial letter to WellPoint can be found here or at here.

For Assistance With Health Industry Concerns

If your organization needs advice or assistance with the proposed regulation, preparing or submitting comments on the regulation or with other health care matters, contact Cynthia Marcotte Stamer at (469) 767-8872 or via e-mail here. 

Vice President of the North Texas Health Care Compliance Professionals Association, Exempt Organization Vice-Coordinator of the Southern States IRS TEGE Council, a Council Member of the ABA Joint Committee On Employee Benefits Council, Past Chair of the ABA Health Law Section Managed Care & Insurance Section, the former Board Compliance Chair of the National Kidney Foundation of North Texas and former Board President of the Richardson Development Center for Children (now Warren Center), Ms. Stamer has more than 22 years experience advising health industry clients about health care operations, regulatory and compliance, reimbursement, staffing, risk management, public policy and other matters.    A popular lecturer and widely published author on health industry matters, Ms. Stamer advises hospitals and other health industry clients about responding to and using these and other quality measures and other related concerns.  Ms. Stamer also publishes and speaks extensively on health and managed care industry quality, regulatory, reimbursement, and other operations, risk management and public policy concerns.  Her insights on these and other related matters appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.  For additional information about Ms. Stamer, her experience, involvements, programs or publications, see here.  

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For More Information

We hope that this information is useful to you.  If you need assistance with auditing or defending these or other health care compliance, risk management, transaction or operation concerns, please contact Cynthia Marcotte Stamer, at (469) 767-8872 or to cstamer@solutionslawyer.net. Ms. Stamer has extensive experience advising clients and writes and speaks extensively on these and other health industry and other internal controls and risk management matters. 

You can review other recent health care and internal controls resources and additional information about the health industry and other experience of Ms. Stamer here.  If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here or e-mailing this information to here.

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