May 17, 1986 |
Blue Cross of Greater Philadelphia has been selected by the federal government to be one of 10 companies that will process Medicare home-health claims. While that may not sound like the greatest thing since sliced bread, consider the alternative. "We could have been out of the home-health business entirely," explained Eugene Ott, Blue Cross' senior vice president in charge of provider relations. As part of the 1984 Deficit Reduction Act, Medicare officials were instructed to pare the number of outside firms processing home-health-care claims from several dozen to 10 regional companies.
December 10, 1993 |
The Department of Justice has begun an investigation to determine whether a clause in Independence Blue Cross' hospital contracts, designed to get the insurer the hospital's lowest rates, is anti-competitive. A Nov. 30 letter to state Insurance Commissioner Cynthia M. Maleski says the department would begin its investigation into Blue Cross' prudent-buyer clause within a few days "to determine whether it violates the federal antitrust laws. " It is signed by Steven Kramer, an attorney in the department's antitrust division.
October 18, 1988 |
Thanks to amendments to proposed changes in the corporate structure of Blue Cross, subscribers will retain a voice in the board of directors of the giant health care insurance company, a Blue Cross official said last night. Blue Cross spokesman Dick Mendenhall said under the amendments passed last night at a subscribers' meeting, individuals can be nominated to the board if they submit petitions representing 5 percent of Blue Cross' subscribers. Formerly 10 percent was required.
March 23, 1988 |
Blue Cross of Greater Philadelphia last year posted its largest gain in subscribers since 1969, adding nearly 60,000 new members, the health insurer reported at its annual meeting last night. Despite the nearly 3 percent increase in subscribers and a 16.5 percent increase in revenues, to $959 million, Blue Cross lost $38.3 million in 1987 as claims and operating expenses increased dramatically. The $38.3 million net loss was equal to 4 percent of Blue Cross' underwriting expenses of $954.
January 12, 1989 |
Two pharmaceutical workers have been accused of swindling Blue Cross out of a total of $84,025 between June 1986 and September 1987 by submitting false claims. District Attorney Ronald D. Castille yesterday said he had the best prescription for the alleged fraud. He charged the two with theft by deception, forgery and conspiracy. The accused are Clarence Jackson, 33, of 17th Street near Wharton, and Curtis Webster, 30, of 12th Street near Jefferson. Prosecutor James Fitzpatrick, chief of the DA's economic crimes unit, said Jackson and Webster were stealing blank invoices while working at Lancaster Avenue Medical Supply, Lancaster Avenue near 41st Street.
January 8, 1988 |
The Blue Cross trust fund of the Fraternal Order of Police has been reorganized to remove it from the union president's control. FOP President Robert Hurst, who supported the reorganization, said it was "important" to place the fund's $2.2 million balance "beyond the reach of whoever happens to be sitting in the president's chair. " The fund, Law Enforcement Health Benefits, has been separately incorporated as a non-profit organization governed by a nine-member board, said board chairman Richard B. Costello.
May 19, 1987 |
A huge backlog of claims to Blue Cross of Greater Philadelphia for major- medical insurance payments has been slashed to a near-normal level. The backlog is down to about 11,000 claims from a high of more than 60,000 in January. A spokesman said the insurer's processing schedule was expected to be back to normal by June. "I fully believe in two weeks we'll have it down to 8,000 or less . . . a level that's normal for this time of year," James R. Vivian, director of the major-medical section, said in an interview last Friday.
August 19, 1986 |
In an important break with the past, Blue Cross and Blue Shield insurance plans would lose their 50-year-old exemption under the sweeping revision of the tax code agreed upon over the weekend. The bill approved by a House-Senate conference committee calls for the nonprofit insurance plans to pay taxes based on their annual earnings and on how much money they have in their reserves. The tax on the Blues is expected to add about $800 million to the Treasury's coffers over a five-year period.
February 2, 1986
It appears that a reasonably salient point has been overlooked in the articles on the surplus in the Blue Cross "reserves. " From personal experience I can truthfully hypothesize that much of this surplus has come from the pockets of those covered by the various plans, both as individual subscribers and as those covered under a plan provided by their employers in lieu of additional direct wages. When the hospitalization plan allows only a partial portion of actual billing amount, as reimbursement to subscribers whose physicians are non- participating, the plan is limiting its expenses while increasing the outlay of the average card holder.
March 15, 1989 |
Several Independence Blue Cross subscribers lashed out against the company's leadership yesterday, then prepared for battle against the process that elects the organization's board of directors. The protesters contended that Blue Cross manipulates its board's elections to guarantee selection of candidates favored by the company's management. Five subscribers, vowing to advocate subscriber rights, submitted their own nomination petitions for the company's 30-member board. "This is the opening gun in a battle against the completely undemocratic electoral process," said Max Weiner, educational director of the Consumers Education and Protective Association, which sparked the challenge.