Under House Bill, Insurers To Disclose Claims Denials

04/25/12 7:34AM By John Dillon
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AP/Toby Talbot
In this 2008 file photo, Dr. Harold Dauerman checks monitors during a catheterization lab heart procedure in Burlington.

 

The House has advanced a bill that requires health insurance companies to disclose the claims they've denied for coverage. If the bill passes, Vermont would become the sixth state to mandate that claims data be made public.

The bill sets broad disclosure requirements on health insurers. They'd have to tell the state how many claims they've denied, how many were appealed, and how many were eventually paid because of the appeal process.

Barre Independent Paul Poirier said the legislation adds a little sunlight into the sometimes confusing world of health insurance.

"That's why we're asking them to extrapolate certain information and file it so that a person can get a little quick blueprint of what the company's history is with claims and their finances and so forth," Porier said.

The bill would also force health insurance companies to release salaries and bonuses paid to top executives. In addition, Poirier said the companies' lobbying and advertising budgets would be available for public review.

The disclosure bill has already passed the Senate and won preliminary approval in the House with only one dissenting vote.

That came from West Rutland Republican Tom Burditt. He said the financial reporting requirement went too far.

"The names, positions, salaries of corporate officers and board members, bonuses and compensatory benefits are none of our business," Burditt said. "And, you know, what industry is next?"

A lobbyist for Blue Cross Blue Shield of Vermont said the company is required to report much of the information already in various documents filed with state regulators.

But Cassandra Gekas, a health care advocate for the Vermont Public Interest Research Group, said the bill strengthens the state's disclosure requirements. She said Blue Cross reports its total claims to the state, but not how many it's refused to pay.

"What this bill is going to do is for the first time require insurance companies to report to the state of Vermont how many claims they deny, which up until now has not been reported at all or been part of any regulatory process in the state," she said. "So not only do they have to report it to the state, it's also going to be available to the public in one easy place."

The disclosure bill comes up for final approval in the House later this week.

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