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Health plan review may be intensified

The state's top HMO regulator calls for outside oversight of insurers' attempts to drop policyholders.

January 30, 2007|Lisa Girion | Times Staff Writer

Consumers, along with physician and hospital groups, urged Ehnes not only to adopt new regulations making rescissions more difficult but also to step up enforcement under the existing law.

For instance, the applications need to be simplified because, in their current format, they invite mistakes, said Scott Glovsky, a lawyer representing several canceled policyholders.

"This frankly is a trap for the unwary," he said. "It's a fraud."

Scott Svonkin, chairman of the Los Angeles County Commission on Insurance, said the Board of Supervisors recently approved a resolution supporting new rules at the state level that would limit revocations.

"It's going to take your department, through regulations, to make the insurance companies do the right thing," he said.

Ehnes also heard from consumers such as Patricia Abbott, who said Blue Shield rescinded her coverage after she had a hysterectomy that the health plan authorized in advance.

She said the plan accused her of concealing three diagnoses that she was unaware were in her medical charts or that were incorrect.

"You're at the mercy of your medical reports," Abbott said.

lisa.girion@latimes.com

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