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Humana fined for violations in Colorado

NEWS IN BRIEF — Posted June 20, 2011

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After reviewing company records from July 1, 2007, to June 30, 2009, as part of a market conduct examination, Colorado insurance regulators found that Humana was violating several state laws and fined the company $299,000.

The state Division of Insurance said in a news release June 6 that it had found, among other things, that Humana had left out important benefit information about mandated coverage, charged rates that hadn't been filed with the state, paid claims late, used the wrong underwriting criteria for small group policies, used "incorrect" utilization review procedures, and failed to follow state rules when canceling members' coverage.

In a company statement, Humana said it "takes seriously our obligations to compliance and our commitment to the highest standards in customer service, claims processing and utilization review. We have and will continue to work collaboratively with the Colorado Division of Insurance to address the issues highlighted in the DOI's market-examination report."

Note: This item originally appeared at http://www.ama-assn.org/amednews/2011/06/20/bibf0620.htm.

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