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N.Y.: Health plans short on info

NEWS IN BRIEF — Posted April 19, 2004

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Most health plans in New York, including Aetna and CIGNA, are doing a poor job of supplying patients with information to help them obtain treatment, as mandated by a state law, says a report from New York State Attorney General Eliot Spitzer.

Spitzer's employees posed as prospective enrollees of 22 health plans, sending the companies letters requesting information on the standards used to decide if various medical conditions were covered by insurance. This information is required to be given to patients under the state's Managed Care Consumer Bill of Rights.

The staff graded the replies received from the insurers, from A to F, and 11 plans received an F. Seven received a D. The only plan that got a B was Empire HealthChoice. None earned an A.

Plans with failing marks included Aetna, CIGNA, and Health Net.

Under the terms of court settlements with U.S. District Court Judge Federico Moreno in Miami, Aetna and CIGNA are required to disclose fee schedule and claim coding information to doctors.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2004/04/19/bibf0419.htm.

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