Sunday, April 25, 2010

Incredibly Stupid Carrier Trick? Maybe. [Updated & Bumped]

[Please scroll down for important update]

It would seem that WellPoint is eagerly looking forward to government intervention, if not outright control:

"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."

If true, this is not only incredibly short-sighted, but morally egregious.

But is this story true?

Certainly we've seen our share of Stupid Carrier Tricks, but we've also seen how the press routinely misses both the facts, and the point. There are a number of facts missing from the stories I've seen, starting with how many of these women had already been diagnosed with breast cancer before seeking coverage, and whether or not this was disclosed on their applications. It would also be helpful to know if there are other health issues involved which might have triggered rescission.

Unfortunately, a lot of this information is probably covered under HIPAA privacy rules, effectively gagging the carrier from coming to its own defense. But I didn't see anything in the news stories thus far which even hint that the reporter tried to ascertain whether or not there was more here than we're being told.

If, and it's a very big "if," WellPoint is simply casting these women off willy-nilly, then they deserve any and all consequences that come their way, and we'll proudly add this episode to our pantheon of the aforementioned Stupid Carrier Tricks.

At this point, however, that would be premature.

UPDATE: [NB: the original post was published on Friday, April 23rd] Well, that didn't take long. Turns out this is actually a "Stupid MSM Trick." Bob just alerted me to Reuter's correction, which pretty much undermines the entirety of the original story. To wit:

"Removes all references to Robin Beaton ... that the insurance company that canceled her policy was not a WellPoint subsidiary."


"Technically, rescission was not the reason Reilling lost her health insurance ... Rather, it was canceled because she did not answer letters from her insurance company requesting information about her employment history."

"Technically." Kinda like saying "technically, Joe didn't rob the bank at all, but he was riding a bike." Unfortunately, the damage has been done to WellPoint's reputation (such as it might be); one can't "unring the bell."

Now, one may take issue with the idea that one's employment history should form the basis for a rescission (I certainly do), but this is a far, far cry from the sensational headline claiming that breast cancer patients are routinely kicked off their plans. But it's of a piece with these kinds of stories (as I mentioned in the original post): go with the sensational (but baseless) headline, paint a stark picture of dire straits, and hit "publish." So much for "professional journalism."
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