GOVERNMENTScores of bogus health plans collect premiums, ignore claimsVictimized patients often can't afford to pay their medical expenses.By Joel B. Finkelstein, amednews staff. March 22/29, 2004. Washington -- Sham health insurers are racking up hundreds of millions of dollars in unpaid medical bills -- leaving patients across the country with the tab and doctors with little chance of getting paid, according to a new government report. Health insurance fraud comes in waves, and the recession has caused the latest upsurge. "The proliferation of the Internet, the increasing number of uninsured and the ever-increasing cost of health care make the perfect breeding ground for these scams," said Sen. Chuck Grassley (R, Iowa) at a recent hearing of the Senate Finance Committee, which he chairs. At that hearing, the U.S. General Accounting Office introduced a report that analyzed federal and state data on 144 unauthorized sellers of health insurance between 2000 and 2002. During those years, the firms sold more than 200,000 policies to employees at more than 15,000 businesses. The unpaid medical bills totaled $252 million. "Companies running insurance scams for the sole purpose of defrauding patients are an outrage," said Yank D. Coble Jr., MD, AMA immediate past president. "It is particularly troublesome that some of the nation's most vulnerable populations ... are direct targets of these charlatans." The plans generally target small businesses by claiming to provide comprehensive coverage at premiums set well below what state-licensed insurers charge. Using local agents and PPO networks, these companies can lend themselves an air of legitimacy. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2004 American Medical Association. All rights reserved.
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The doctors are in the house
The AMA's House of Delegates is holding its Interim Meeting Nov. 7-10 in Houston, addressing issues such as health system reform and physician payment. Meeting coverage - Slideshow Feature articlesHealth reform review The Massachusetts experience Litigation stress Being sued is personal as well as professional Comprehensive coverage
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