WASHINGTON, D.C.— In his continued effort to hold health insurance companies accountable for how well they cover and protect patients, Senator John D. (Jay) Rockefeller IV, Chairman of the U.S. Senate Committee on Commerce, Science, and Transportation, today expanded his investigation into health insurance companies’ policies toward covering medically necessary care.
Chairman Rockefeller sent letters today to the CEOs of Coventry Health Care and Aetna, Inc. requesting detailed information about their policies toward covering “stress tests” for their Delaware policyholders who are showing symptoms of heart disease. The requests follow recent news reports in the Wilmington, Delaware News Journal that insurers in Delaware have refused to approve these tests for their patients. They also follow the announcement by Delaware Insurance Commissioner Karen Weldin Stewart that her office has opened a market conduct examination into the matter.
“I am encouraged that Commissioner Stewart has launched an investigation into BCBSD’s, Aetna’s and Coventry’s health care practices,” Chairman Rockefeller said. “I intend to keep a close watch on the health insurance industry, and to ask the tough questions about how they do business – especially now that we have passed a landmark health care reform bill. Denying medically necessary services to patients showing signs of serious heart disease is not tolerable. I will continue to fight to make sure Americans are getting the health care they have paid for and deserve.”
KEY BACKGROUND INFORMATION
According to doctors quoted in the News Journal, when they have recommended stress tests for patients experiencing chest pain and other symptoms of coronary heart disease, the tests have been determined to be not medically necessary, and coverage has been denied. These doctors claim that a third-party claims administration company called MedSolutions has been hired by these insurers to manage this “pre-approval” process.
The News Journal previously reported that Blue Cross Blue Shield of Delaware (BCBSD) also refused to pay for stress tests for policyholders who were showing signs of coronary heart disease, including severe chest pain. Chairman Rockefeller requested more information from BCBSD on March 25, 2010. More information can be found here.
Since taking the helm as Chairman of the Senate Commerce Committee, Senator Rockefeller has made protecting consumers from unfair health insurance practices – and making sure they get the care they’ve paid for and deserve – a top priority. Chairman Rockefeller will continue to crack down on companies that are taking advantage of American families.