Today’s News Journal updates the status of the investigations into the denials of prescribed tests for heart patients by BCBSD. Aetna is also now part of the doctors’ complaints — Aetna is using the same pre-authorization firm as BCBSD.
Now that the News Journal has been looking into this pretty intently, and Senator Jay Rockefeller (from West Virginia) has asked for information on these denials, we find that Delaware’s IC has decided to open up her own investigation:
Stewart said her office will contract with third-party examiners to probe the pre-authorization procedures of the three carriers.
The insurance department announced plans to open its investigation after receiving several more complaints of pre-authorization denials in the past week, Stewart said Saturday from Denver, where she is meeting with insurance commissioners from other states. Stewart could not put a precise number on the amount of complaints that have reached her office, but said she needed to see evidence of a pattern of questionable behavior before opening a formal investigation.
“A pattern is three [complaints], at least three,” Stewart said.
An outsourced review of BCBSD pre-authorization procedures (why can’t the already paid staff do this?), no idea how many complaints received (really? After almost a week this issue has been in the spotlight?) and her definition of a pattern.
Check. And after all of this there will be public hearings. But months down the road. Wonder if these get outsourced too.
Check again.
So the News Journal finds a pattern and the IC’s office will take months to look into it. One of the things I wonder is if there were people who the News Journal has reported on here who actually did complain to the ICs office too. We already know that a request from Senator Jay Rockefeller was enough for BCBSD to loosen up their requirements. The question at end is whether Delawareans with pre-authorization issues will always need to count on the attention of Senator Rockefeller to get local insurance companies to do what they get paid to.