Friday, October 30, 2009

The Medicare Fraud Expansion Act

It's amazing how on almost every page of this healthcare reform bill there is something to get upset about. On page 29 it says that insurers cannot rescind someone's insurance in either the indivudual or group markets unless there is clear and convincing evidence of fraud AND ONLY AFTER external 3rd party review. In other words even with clear and convincing evidence of fraud, an insurer cannot throw somebody off the plan. They first need approval from a third party, which my guess will be a very long process. In the interim, my guess is that the insurer will legally be bound to continue to pay what they believe are fraudulent claims, since if they don't wont't they get sued for rescinding coverage in voilation of this law? Sounds like a great way to expand massive medicare/medicaid-type fraud to the private insurance market.

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