Sunday, July 25, 2010
WellPoint CEO Angela Braly
The fight may be over in Congress involving healthcare reform, but it is still being waged at the regulatory level in many states as insurance companies seek to include various overhead expenses under the heading “patient welfare.”
The new federal reform law requires insurers to spend 80% of all premiums on care for patients. It’s been left to the states, however, to decide what expenses are deemed patient-oriented.
WellPoint, parent company of Blue Cross, wants the cost of verifying doctors’ credentials in its networks to fall under the 80% rule. Aetna wants expenses related to uncovering fraud to be considered non-administrative, and some insurers even want sales commissions for insurance agents and taxes paid on investments to be rolled into the 80% category.
-Noel Brinkerhoff
For Insurers, Fight Is Now Over Details (by Reed Abelson, New York Times)
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