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On August 1, 2007, New York’s Governor Spitzer signed into law S.3986-A, a bill intended to decrease friction between managed care plans and their participating providers on certain sensitive issues.  Most significantly, if a health plan requires that certain health care services be preauthorized in order to be covered, then once a service has been preauthorized and performed, the plan may not thereafter deny coverage for the service. 

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Read More New York Enacts Managed Care Law Reforms

On January 17, 2007, lawmakers in the House and Senate introduced identical bills (H.R. 506 and S. 325) aimed at funding innovative State initiatives that expand coverage and access to the uninsured and improve quality and efficiency in the health care system.  The bills, the “Health Partnership Act”

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Read More Important National Health Care Reform Bills Awaiting Action By Congress

The Connecticut General Assembly recently enacted legislation (Public Act 07-113), signed into law by Governor M. Jodi Rell on June 12, to prohibit health insurers or HMOs (termed “health care centers” under Connecticut law) from engaging in the practice of “post-claim underwriting.” 

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Read More Connecticut Outlaws Post-Claim Underwriting by Health Insurers

Given the escalating costs of covering legitimate health care services, the last thing the health insurance industry needs is to be paying for services that were never rendered.  Fortunately, state and federal laws provide harsh penalties for this sort of fraud. 

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Read More Group Health Incorporated Spots Insurance Fraud in Alleged Brain Surgery Scam