Connecticut Health Insurers Facing Provider Complaints About Delayed Payments
Over the last three years, eight Connecticut health plans were fined almost $500,000 for illegal delays and denials of payment to providers, and at least six health plans have changed business practices to comply with state law, which requires insurers to pay interest on valid claims not paid within 45 days, the AP/Hartford Courant reports. According to a yearlong review by the Waterbury Sunday Republican, out of 1,581 complaints against the eight state health insurers that the state Department of Insurance determined were fully or partially justified, 70% were related to delays in payments and 10% were related to coverage denials. The review also found that over a one-year period, Physicians Health Services, now Health Net, withheld or denied payments the most, with $307,968 in withheld legitimate claim payments. Alice Ferreira, a spokesperson for Health Net, said that the health plan did not purposely delay or deny payments, adding "Those [withheld claims] all reflect Health Net two to three years ago. What Health Net is today is quite different." State insurance department officials said that number of justified complaints against insurers is "small compared with the millions of dollars collected in premiums," the AP/Courant reports.
Lawsuits
Connecticut Attorney General Richard Blumenthal (D) said that his office has received more than 3,000 complaints about delayed payments over the last four years, which spurred the creation of a special investigation unit. In September 2000, Blumenthal filed a federal class-action lawsuit in U.S. District Court, alleging that the Connecticut subsidiaries of Cigna, Oxford Health Plans, Anthem and Foundation Health Systems failed to reimburse providers in a timely fashion. "Health care delayed is health care denied," Blumenthal said, adding, "That's why a victory in our lawsuit would be a profoundly powerful signal on the legality of many of these prevalent practices that deny patients the quality medical care they desire" (AP/Hartford Courant, 8/11).
