August 8, 2013 |
The insurance company for the contractor being sued by people injured in the Market Street building collapse contends that the contractor's insurance policy is invalid because he lied on key application documents. Berkley Assurance Co. of Iowa filed a suit Monday afternoon in Philadelphia Common Pleas Court arguing that Griffin Campbell misrepresented his history and the details of the demolition. Six people were killed when a wall of the building being demolished collapsed onto the Salvation Army thrift store next door June 5. The suit also says that because Campbell did not pay a policy premium in April, the insurance policy was canceled and not in effect on the day of the collapse.
July 29, 2013 |
Carmen Mendez, 62, rarely went without health insurance over 25 years as a child care worker in the city. But after starting a new job in early 2012, she missed the company's open enrollment period and her coverage lapsed. And before she could get enrolled, she fell ill with colon cancer. "I've always had insurance. This is the first time I don't," Mendez said. "I'm worried and anxious every single day. " Uninsured and sick, Mendez sought help at Esperanza Health Center, where they secured charity care for her at Temple University Hospital for surgery and chemotherapy.
July 21, 2013 |
New Jersey residents are being wrongly denied insurance for inpatient treatment for substance abuse and mental illnesses, forcing them to choose between paying for expensive care or being put on the streets, a group of patients, family members, and health-care providers told a legislative committee Thursday. The group told the Senate Legislative Oversight Committee that the state should take a more active role in advocating for patients, saying that those with behavioral or substance-abuse issues aren't treated the same as those with physical ailments.
July 20, 2013 |
New Jersey families received an average $104 rebate, and Pennsylvanians saw $77, from their health insurers last year under a provision in the Affordable Care Act that limits companies' profit and overhead. So-called medical loss ratios require insurance companies to spend at least four-fifths of premium dollars on actual care or quality improvement - 80 percent in the individual and small-group markets, and 85 percent in the large-group market. If audits find that a company spends less than that, policyholders get a rebate.
July 18, 2013 |
Three major Philadelphia-area health systems announced a partnership Tuesday to jointly manage the health benefits and care for their tens of thousands of employees. Einstein Healthcare Network, Abington Health and Aria Health unveiled the development of a jointly-run company that will manage insurance and care for their combined 30,000 employees and family members. The three systems combined currently pay premium revenues of about $100 million annually, though how much each system will invest into the partnership has yet to be determined.
July 16, 2013 |
Medicare has two more years to live than previously thought. The program's trustees recently estimated that the "depletion date for the trust fund is 2026, two years later than was shown in last year's report. " But that conclusion is less a vote of confidence than a two-year stay of execution. Absent substantial reform, Medicare will eat up more and more of our nation's resources even as it provides less and less to beneficiaries. The report notes that Medicare expenditures will increase faster than earnings or the economy.
July 11, 2013 |
Finding a cure for Alzheimer's disease remains a dream for patients suffering from the debilitating brain condition, family members struggling to help them, and pharmaceutical companies hoping to make billions of dollars treating them. But there is no consensus on even the best direction of research, and that uncertainty has affected a Philadelphia subsidiary of Eli Lilly & Co., Avid Radiopharmaceuticals. The Centers for Medicare and Medicaid (CMS) said last week that it probably would not pay for as many of the diagnostic tests Lilly hoped it would when the drug giant bought Avid in 2010.
July 8, 2013 |
Two days after Erik Friedman was born, his parents applied for coverage under Pennsylvania's universal Children's Health Insurance Program. Six months later, they got it. What happened in between were 86 phone calls, two lost applications, a calculation error that tripled their income (and raised their premium), incorrect advice that they should (and did) drop their baby's catastrophic health insurance to qualify, multiple promises of responses that never came, and collection agency letters for hospital bills, which, of course, hadn't been paid.
July 6, 2013 |
In a lawsuit with big implications for state utility customers, Public Service Enterprise Group and three of its subsidiaries accused 10 insurance companies of shortchanging them $456 million for damage to their power grid. Insurers say they will cover only $50 million in payouts, arguing that policies restrict reimbursements above that amount in specific flood zones. PSEG and its subsidiaries filed a lawsuit June 18. Utility customers could end up paying the bill to repair the infrastructure if the court upholds the insurance companies' view.