Blue Cross Of California Will Stop Asking Physicians For Information About New Applicants' Pre-existing Conditions

Main Category: Health Insurance / Medical Insurance
Also Included In: Primary Care / General Practice;  Public Health
Article Date: 14 Feb 2008 - 8:00 PST

email to a friend   printer friendly   view / write opinions   rate article

Blue Cross of California on Tuesday said it would stop sending letters to physicians asking them to report pre-existing medical conditions that could be used to rescind patients' health care coverage, the Sacramento Bee reports (Griffith, Sacramento Bee, 2/13). The insurer has been sending physicians copies of new patients' health insurance applications along with a letter advising them to immediately report any "condition not listed on the application that is discovered to be pre-existing." In the letter, Blue Cross says the company has the right to rescind members' coverage if patients fail to fully disclose their medical history, including "pre-existing pregnancies."

The California Medical Association on Friday sent a letter to state regulators urging them to order the insurer to stop requesting the information. CMA told state regulators that asking doctors to share patient information with insurers is "deeply disturbing, unlawful and interferes with the physician-patient relationship." CMA President Richard Frankenstein said the policy could prompt patients to "stop telling their doctors anything they think might be a problem for their insurance and they don't think matters for their current health situation." Doctors groups that received the letter from Blue Cross said the request was the first of its kind that they have received, the Los Angeles Times reports (Girion, Los Angeles Times, 2/12).

Blue Cross said it has sent such letters for several years and has not received any complaints previously (Colliver, San Francisco Chronicle, 2/13). However, amid growing criticism following the Times article, Blue Cross in a statement said that it "determined this letter is no longer necessary and, in fact, was creating a misimpression and causing some members and providers undue concern" (Sacramento Bee, 2/13).

CBS's "Evening News" on Tuesday reported on Blue Cross' letter to physicians. The segment featured comments from Santa Monica-based physician Jane Spiegel; Parvin Mottaghi, a former Blue Shield member; and Frankenstein (Tracy, "Evening News," CBS, 2/12). Video and expanded coverage is available online.

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.