Published Apr 22, 2010
netglow, ASN, RN
4,412 Posts
"...They had no idea that WellPoint was using a computer algorithm that automatically targeted them and every other policyholder recently diagnosed with breast cancer. The software triggered an immediate fraud investigation, as the company searched for some pretext to drop their policies, according to government regulators and investigators."
(By Murray Waas updated 10:14 a.m. CT, Thurs., April 22, 2010, msnbc.com) See full story link below.
Insurer targeted breast cancer patients to cancel - Health care- msnbc.com
HM2VikingRN, RN
4,700 Posts
None of the women knew about the others. But besides their similar narratives, they had something else in common: Their health insurance carriers were subsidiaries of WellPoint, which has 33.7 million policyholders -- more than any other health insurance company in the United States.The women all paid their premiums on time. Before they fell ill, none had any problems with their insurance. Initially, they believed their policies had been canceled by mistake.They had no idea that WellPoint was using a computer algorithm that automatically targeted them and every other policyholder recently diagnosed with breast cancer. The software triggered an immediate fraud investigation, as the company searched for some pretext to drop their policies, according to government regulators and investigators.Once the women were singled out, they say, the insurer then canceled their policies based on either erroneous or flimsy information. WellPoint declined to comment on the women's specific cases without a signed waiver from them, citing privacy laws.
None of the women knew about the others. But besides their similar narratives, they had something else in common: Their health insurance carriers were subsidiaries of WellPoint, which has 33.7 million policyholders -- more than any other health insurance company in the United States.
The women all paid their premiums on time. Before they fell ill, none had any problems with their insurance. Initially, they believed their policies had been canceled by mistake.
They had no idea that WellPoint was using a computer algorithm that automatically targeted them and every other policyholder recently diagnosed with breast cancer. The software triggered an immediate fraud investigation, as the company searched for some pretext to drop their policies, according to government regulators and investigators.
Once the women were singled out, they say, the insurer then canceled their policies based on either erroneous or flimsy information. WellPoint declined to comment on the women's specific cases without a signed waiver from them, citing privacy laws.
http://www.reuters.com/article/idUSTRE63L2LS20100422
oramar
5,758 Posts
This is a close to murdering a person you can get without actually pulling the trigger.
This angers me so! I am very excitable regarding this issue, and seriously could not be in the same room dealing with these people. I'd have to be frisked.
wsuRN09
118 Posts
Wow, so what's the point of insurance if they not only deny you for a pre-existing condition, but now they find a way to drop you when you become ill? This makes me sick....
morte, LPN, LVN
7,015 Posts
....money....
DogWmn
575 Posts
Sad but no surprise, insurance companies are inherently evil.
Batman25
686 Posts
It's deplorable beyond words. Disgusting.
Ginger's Mom, MSN, RN
3,181 Posts
This is fraud and I hope they get there right to sell insurance janked.
chacomom
54 Posts
Having survived breast cancer for 2 years, I live in fear of the same problem.
Medic/Nurse, BSN, RN
880 Posts
Until we start with ACCOUNTABILITY for making a bonehead (though profitable) decision and PUT THEM IN JAIL - this kind of CORPORATE issue will happen. Make this a company mandate - cost one their life - be criminally charged and suffer the necessary FATE!
JAIL.
No insurance + CANCER = LITTLE to NO Treatment = DEATH
Sounds like fraud (nah - MURDER) to me. Many knew what their decisions would mean - so, lets make them explain - to a jury.
Did I mention - JAIL.
:angel:
Chico David, BSN, RN
624 Posts
The basic business model of health insurers is to exclude the sick from coverage. It's central to what they are. As long as you have a system in which for-profit insurers compete with each other, finding ways not to cover the sick is going to be part of their business plan. The new health insurance law is supposed to ban that practice, but my money is on the insurers to find some way around that law. And in a model where collecting premiums is the source of revenue and providing care is considered a "loss" - that's the term they use - we will have new and better strategies to avoid providing care.
And who can blame them for doing what they are set up to do - make profit at the expense of their policy holders? It's like blaming a lion for killing deer. We wouldn't be dumb enought to let a lion loose on the school playground, but we let these insurers control our access to care.