INSURANCE BRIEFS

INSURANCE BRIEFS

BLUE CROSS OF MEMPHIS

AGREES TO PAY REFUNDSBlue Cross-Blue Shield of Memphis has agreed to pay $440,000 following an investigation into allegations of improper billing of customers, the Tennessee attorney general's office said.

More than 1,600 customers eligible for refunds will receive notices in the mail, which they must fill out and return.

Blue Cross-Blue Shield agreed to the settlement without admitting any wrongdoing.

The company, operating through Memphis Hospital Services & Surgical Association Inc. and Southern Health Plan Inc., was accused of improperly figuring the amount of copayments owed by customers filing medical claims.

Those customers are eligible for total refunds of $385,000, the state said. Blue Cross-Blue Shield also has agreed to pay attorney fees and make donations to local charities selected by the attorney general's office.

Those donations will cover refunds under $20.

IOWANS SUE BLUE CROSS

OVER CO-PAYMENT PLAN

DES MOINES, Iowa - A group of southeast Iowans has sued Blue Cross and Blue Shield of Iowa over the insurer's billing practices.

According to the lawsuit filed in North Lee County District Court, Robert J. McConnell, Rebecca Hand, Rae J. Cooper, Jim Bleything, Wade Erickson and Charlie Newman claimed they pay more for the medical services they receive then the insurer leads them to believe.

The six people have filed the case on behalf of several groups including self-employed workers, government workers and members of the Iowa Farm Bureau Federation.

Under a co-payment agreement with Blue Cross and Blue Shield, they are required to pay a percentage of their medical expenses - usually 20 percent. The lawsuit claims they pay a percentage of the billed amount instead of a percentage of the actual expense of the care they receive.

IASD Health Services Corp., the parent of the Iowa Blues, declined to comment on specifics of the suit.

CONN. TO PROBE INSURERS

ON MATERNITY BENEFITS

HARTFORD, Conn. - Connecticut health insurers that rush mothers and newborns out of hospitals within hours of delivery may soon face legislation requiring them to pay for longer stays, a state official said.

Attorney General Richard Blumenthal said he was investigating the maternity coverage provided by 68 health-care insurers providing coverage to Connecticut residents.

He has sent a questionnaire to all 68 companies on their coverage rules and said that, depending on the results, he may press for new laws governing maternity insurance.

Along with asking about time limits, the survey seeks information ranging

from insurers' policies for routine, Cesarean and premature childbirth to any incentives or disincentives involved in the number of medically necessary extensions.

MD. RATING PROPOSAL

CRITICIZED BY NAII

DES PLAINES, Ill. - The National Association of Independent Insurers has labeled as "gerrymandering" a recommendation by a Maryland governor's

commission that insurance rating territories in Baltimore be altered in a manner that will lower premiums only for African-Americans.

The recommendation would require the insurance commissioner to "reduce the correlation between the racial composition of rating territories used by insurance companies and automobile insurance costs" and to lessen "the impact of territorial rating practices on African- Americans."