Health Insurance
Doctors With Histories of Big Malpractice Settlements Work for Insurers, Deciding If They’ll Pay for Care
Doctors working for health insurers can rule on 10,000 or more requests for care a year. At least a dozen were hired by major insurance companies after being disciplined by state medical boards or making multiple or outsized malpractice payments.
Health Insurers Have Been Breaking State Laws for Years
States have passed hundreds of laws to protect people from wrongful insurance denials. Yet from emergency services to fertility preservation, insurers still say no.
Insurance Executives Refused to Pay for the Cancer Treatment That Could Have Saved Him. This Is How They Did It.
A Michigan law requires coverage of cancer drugs. One insurer came up with a “defensible” way to avoid paying for treatments that offered Forrest VanPatten his last chance for survival. “We crossed the line,” says a former executive.
You Have a Right to Know Why a Health Insurer Denied Your Claim. Some Insurers Still Won’t Tell You.
Federal regulations require insurers to promptly hand over records to patients facing claim denials. Some insurers only turned over their files after ProPublica reached out.
Impact of Our Reporting
Health Plans Can’t Dodge Paying for Expensive New Cancer Treatments, Says Michigan’s Top Insurance Regulator
After ProPublica reported on a health insurer that refused to cover the only medicine that could save a cancer patient’s life, Michigan insurance regulators clarified that, by law, many plans must pay for any clinically proven treatments.
Representatives Propose Ban on Insurers Charging Doctors a Fee to Be Paid Electronically
After a ProPublica investigation examined how giant insurers and their intermediaries are imposing fees on doctors and hospitals for electronic payment, a bipartisan group of lawmakers has introduced a bill to end the practice.
Congressional Committee, Regulators Question Cigna System That Lets Its Doctors Deny Claims Without Reading Patient Files
The probes follow an investigation by ProPublica and The Capitol Forum that Cigna allows its doctors to reject hundreds of thousands of claims a month.
