Insurance Commissioner is Failing Aggrieved Patients
That title is stolen from the News Journal Opinion page today, whose writers I have to give some credit to today. And the Insurance Commissioner in question is our own Karen Weldin Stewart.
They highlight an odd bit of business, where Senator John D. Rockefeller, D-W.V has written to Delaware Blue Cross to ask them to provide detailed documentation of why they would deny cardiac testing prescribed by doctors to patients exhibiting symptoms of heart failure.
In the letter to Timothy Constantine, BCBSD’s chief executive officer, Rockefeller asked for information on procedures used to evaluate requests for the advanced stress tests and probed the insurer’s contract relationship with a Tennessee company, MedSolutions, that handles claims submitted in advance of the tests.
Rockefeller asked BCBSD to provide the material to the committee by April 16, including the amount of pre-authorization requests for diagnostic heart tests BCBSD has received in the last five years, how many it has approved, and how many it has denied.
Prior to Senator Rockefeller’s request, the News Journal itself did some detailed reporting on others in Delaware being denied these tests earlier this week and it took a US Senator — one not from Delaware, mind you — to ask enough questions to get BCBSD to actually call off these denials.
Where’s our IC? She claims to have gotten one complaint only and also doesn’t want to talk about this issues citing privacy issues. Except there have been multiple people who have been denied these tests who were willing to go on the record with the News Journal. The NJ OpEd:
It appears Commissioner Weldin-Stewart has dropped the ball here.
There has been plenty of information published, with input from physicians and patients, none of whom seem overly worried about violating their own privacy.
They simply want answers, which is what the insurance commissioner should be seeking.
It’s a bit disconcerting that a U.S. Senate committee is jumping into this fray while the state’s insurance commissioner continues to seek more information before beginning a full investigation.
Exactly. When the local paper and a US Senator are doing more to address a problem with an insurer in Delaware than the person who is paid taxpayer dollars to address these issues, I’ve got to ask — again — what this IC is actually doing for people in this state.
This is really a consistant theme running through many different stories, whether it’s health care, the financial sector, transportation, or any of a number of other fields — the problem is not so much the regulations as it is the regulators. I think the answer is some combination of better regulations and more that “run on automatic”, better and more neutral regulators, and constant oversight by us all.
And on the “better regulators” theme, can someone tell me why the hell IC is an elected position to begin with? Are voters the best judge of competency on this?
The IC office and programs are funded by the insurance industry itself. We are probably lucky the IC is elected rather than appointed… at least with elections there is a chance of one day electing an actual people’s advocate.
Scott – For the same reason treasurer and auditor are, and recorder of deeds and register of wills in some counties … to provide more opportunity for rising politicians or sinecures for allies and cronies.
Stewart had better have some proof that she is getting after this — I guess we’ll find out once the US Senate opens it up. This is true to the meaning of Dealth Panel = Health Insurers. If the IC didn’t act to throw the book at them when she met with them about their process then she will be just as culpable.
Yes, I also wondered why it took Jay Rockefeller to get this story out there.
Woah.
Did Nancy just call out her pal Karen?
anon: It’s called the rats leaving the sinking ship. This kind of thing was bound to happen with this total joke of an IC and it probably wasn’t the first time. We’re just hearing about this one because someone took it to Rockefeller instead of giving up. The only plausible explanation would be that the insurer and its contractor paid her off for ignoring the complaints. Nothing else makes sense.
I thought our previous IC, Matthew P. Denn, did a pretty good job.
Denn used it as a stepping-stone, is all. And he really didn’t have to do much to do a better job than Donna Lee Williams.
Stewart got some splaining to do! WE all knew when she came back from NY loaded with bucks…that insurance fix was in.
My sister-in-law was recently denied a stress test by Aetna (who paradoxically…she works for). Long Story short..She had a minor heart attack 2 weeks ago (she’s fine now). I’m curious if some of the turn-downs are from dated care decision trees. For a long time, Heart Disease was under/missed diagnosed in women and even more so for Black women. I’m thinking that even though Physicians are now more aware of heart disease in women, insurance companies aren’t.
just kiddin’: No need for Stewart to explain anything because it was clear almost as soon as she was sworn in that she got herself into office for personal financial gain. The question is how long can she get away with it. Her fourteen months in office are fourteen too many.
That’s interesting Mark because insurance companies do seem to call treatments experimental for a long time. I wonder if stress tests for women are “experimental.” The explanation in the newspaper article was that they want to limit exposure to radiation.
The IC office is a disgrace. I (unfortunately) am required to deal with the office quite a bit. Call one day and they answer you with one anser. Call another and the answer is different. Do continuing ed credits count for 3 or 5 credits? depends of if it tuesday or thursday? Is this priduct licensed in DE? on wednesday it is on thursday it is not. the office is a fiasco.
UI, then I must be glowing as I’ve been getting an annual stress test for the last 15 years 🙂
Will wonders never cease! Staunch KWS toady Nancy Willing has finally seen the light. But in all fairness, Nancy, you should admit you’re stearing clear of her so you won’t be dragged down into her inevitable crash. We won’t mind. Congratulations on your epiphany nonetheless.
I think this is unfair to KWS. If you hired a color-blind person to paint your house, then got upset that the color scheme was horrible, blaming the handicapped person you yourself hired is a bit disingenuous. We hired a person here, KWS, who has neither the experience nor the brains to handle pretty complex issues. Even if she has the best intentions in the world, she is simply incapable of making any difference as IC.
The issue now is how do we fix what we ourselves (i.e., Delaware voters), have created? Do we wait for the next election, or demand a recall?
UNFAIR to KWS??? Reis, don’t cast her as a victim of poorly informed voters who bought into the myth she created of being some kind of expert. What’s even worse, her intentions when she ran for the IC’s office in the three elections since 2000 were just as contemptible as her lies about her non-existent education and experience. She never intended to serve Delawareans but only herself and her cronies, which she’s done so arrogantly and brazenly that people are finally catching on to her crooked agenda. The Delaware media and political establishment who knew the truth from the beginning and could have prevented her election chose instead to let her get away with her lies. If you blame anyone, blame them.
Gabriel, you should wait to jerk your knee until you are certain that the writer doesn’t have his tongue planted in his cheek.
Donna Lee Williams was elected for one reason only: To take Delaware Blue Cross/Blue Shield private. She was a lobbyist for them before getting elected.
Maybe Denn was only doing a good job with an eye on higher office, but at least it gave him motivation to avoid having a bunch of people with zippers on their chests from talking about what an incompetent dolt he is.
Anon: Is it worth taking the chance on finding someone who fights for individuals if we have to put up with industry shills like DLW and KWS in the meantime?
Ok Cassandra, you got me. But in Delaware a comment like Reis’s being serious isn’t totally inconceivable.