Illinois Blue Cross settles allegations that it denied sick kids coverage

Illinois Blue Cross settles allegations that it denied sick kids coverage

Illinois’ largest health insurance company will pay $25 million to settle allegations that it denied coverage to sick children in need of nursing care by “fraudulently” shifting their claims to Illinois’ Medicaid program, state and federal prosecutors said this morning.

The settlement, reached by Illinois Attorney General Lisa Madigan and U.S. Attorney Patrick Fitzgerald, follows several years of complaints from patients and their families. The patients reached out to Madigan’s office after their claims were denied by Blue Cross and Blue Shield of Illinois.

The cost of the medical care, which included so-called private-duty nurses for sick children and other ill patients, should have been covered by Illinois Blue Cross, but instead was shifted to Medicaid at a cost of nearly $12 million, prosecutors said. The claims were denied based on “internal, undisclosed guidelines that were more restrictive than the language provided to patients in plan policy materials,” Madigan’s office said.

“Blue Cross Blue Shield’s inappropriate denial of legitimate claims placed an undue burden on the state’s finances,” Madigan said in a statement. “My office is committed to holding health care insurers accountable on behalf of the people of Illinois for this type of deception and fraud.”

http://chicagobreakingbusiness.com/2011/02/illinois-blue-cross-settles-claims-it-denied-sick-kids-coverage.html

Denial of care for sick kids...:mad:

Its like No-Fault Negligence

I really, REALLY don't see what they bring to the table. But they rip off the public, refuse coverage to the neediest, and dump their high cost policy holders onto the rest of us for their own profit.

Is this one of those deals where a corporation has all the rights of a person? How long would a person be tossed in the clink for this kind of fraud? Or do corporations get all the rights but have none of the responsibilities of a person?