Blue Cross California fined for improperly denying coverage
Compliance Monitor, October 4, 2006
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California regulators imposed a $200,000 fine on Blue Cross of California for revoking health coverage to a woman suffering from kidney dysfunction because she failed to tell the insurer that she had surgery for acid reflux disease 23 years prior. Her doctor said the acid reflux surgery was unrelated to her current condition, the San Francisco Chronicle reported.
Regulators said they believe the insurer improperly dropped a patient for concealed health information. Representatives from the insurer said they did not believe they had acted improperly in this instance, were disappointed by the state's actions and that they were trying to resolve the case that resulted in the fine.
The state Department of Managed Health Care, which regulates health maintenance organizations is also looking into similar situations at Blue Cross of California and Kaiser Permanente.
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