Workers Comp Zone

GETTING TOUGH WITH HEALTH INSURERS

Major healthcare reform this year in California looks dead as a doornail.

Last year’s special session failed to produce an airtight deal, and the budget debacle and recession are setting the stage for an ugly legislative session.

But-to its credit-the Schwarzenegger administration appears ready to get tough with healthcare insurers who try to rescind the policies of sick
plan participants.

Blue Shield has filed an appeal in Hailey vs California Physicians Service, requesting the California Supreme Court take the case. The Court of Appeals had upheld some limits on healthcare recissions. The Hailey decision can be seen here:
http://www.courtinfo.ca.gov/opinions/do … 035579.PDF

Now the California Department of Managed Care has decided to file an “amicus” brief (“friend of the court” brief) urging the California Supreme Court NOT take up the Hailey case on appeal. If the Supreme Court refuses to review Hailey, Hailey is “the law”. Meanwhile, the administration is meeting with insurers to encourage development of new policies on recissions.

Recently there have been high-profile jury verdicts in some cases against insurers who tried to rescind coverage from sick people. Legislative hearings are on the horizon.

Check out today’s piece by John Howard and Anthony York in the Capitol Weekly:
http://www.capitolweekly.net/article.ph … 67binwg6z4

Stay tuned.

Julius Young
http://www.boxerlaw.com/practices/workerscomp.html

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Category: Political developments