Fed Initiates Medicare Bans on Aetna

[The Straight Story]

Fed Initiates Medicare Bans on Aetna



The Federal Government has taken punitive action against the insurance giant Aetna by announcing that it will bar Aetna from signing on any new Medicate patients until corrective action is taken by the company that has bogged down the process of providing seniors with the prescription drug orders. A great many complaints had been filed against the insurance company due to lack of quality service. This prompted the Center for Medicare and Medicaid Services (CMS) to take effective action. Until Aetna takes the steps required to correct its deficiencies and make sure they do not occur again, enforcement action will not be lifted. The ban takes place on April 21, 2010 so Aetna does have the benefit of a few days to launch corrective action.

Common problems Aetna was guilty of included slow processing and appeals, not applying low income subsidies in a timely manner, and other unnecessary delays. The severity of the problems that can derive from such non-action prompted numerous complaints. The fact that action was taken against Aetna should not come as a surprise.

Outreach to those customers that have been adversely affected by Aetna is being conducted by CMS. This could possibly aid in eliminating many problems in the future.

http://www.techjackal.net/other/2010/04/10/fed-initiates-medicare-bans-on-aetna/

[whoneedstickets]

1. This story illustrates how we get to a public option...

I know many on this board are upset that the private insurance companies have benefited from the insurance purchase mandate in HCR.

Frankly, I think of it as a taxation system (taxes are mandated too) with a service fee for administration accessed by a management and oversight firm with an incentive to control costs -- not great, but not the end of the world either.

But this story shows how private insurers' greed may lead them to overstep or avoid the key restriction in the plan. It will be the accumulation of abuses that results in public option or universal health care.

[indepat]

2. I'm far more certain a vast number of abuses will accumulate than that those abuses will result

in a public option or universal health care, but here is hoping. :-)

[ellenfl]

3. i'm am also expecting the private insurers to inadvertently bring us the po. eom