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South Carolina BlueCross Expands Colonoscopy Coverage; New National Screening Guidelines Issued

Written by Rob Kurtz and Stephanie Wasek
Monday, 17 March 2008
BlueCross BlueShield of South Carolina will now cover preventive colonoscopy screenings once every 10 years for all its fully insured members 50 and older, the insurer announced.
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California Appeals Court Rules Hospitals Needn't Disclose Patient Discounts

Written by Rob Kurtz
Thursday, 13 March 2008
A California state appeals court has ruled that Sutter Health and Alta Bates Summit Medical Center were not in violation of the state?s consumer protection laws when they did not disclose the existence of a discount policy. The issue of patient and self-pay discount polices is becoming increasingly important for ASCs and hospitals as they deal with uninsured patients and, equally importantly, with high deductible plans.
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National Media Reports on Never Events as Medicare Reimbursement Change Approaches

Written by Rob Kurtz
Thursday, 13 March 2008
For years hospital errors were corrected and billed as part of a patient’s treatment; in just a few months, Medicare will change that practice, and now, national media are starting to pay attention.
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GI Catches a Break: Aetna Delays Controversial Sedation Policy

Written by Rob Kurtz and Stephanie Wasek
Wednesday, 12 March 2008
Aetna has announced that it will delay its plans to institute a new policy under which the insurer would cover monitored anesthesia care only for high-risk patients, according to the company’s web site.
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The Empire Strikes Back: N.Y. Probes Underpayments by Insurers to Out-of-Network Providers, Patients

Written by Stephanie Wasek
Wednesday, 12 March 2008
After several years of insurance companies aggressively setting limiting rates as to what they will pay out-of-network providers, New York has launched an investigation into whether insurance companies are unfairly setting those rates and causing patients to pay disproportionately high amounts of provider bills. Health insurers are being probed as part of a healthcare industry-wide investigation to determine whether they have schemed to “defraud consumers by manipulating reimbursement rates,” according to the N.Y. Attorney General’s Office.
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