INSURANCE-LETTER for Monday, January 6, 2002 INSURANCE-LETTER is published daily Monday - Friday, transmitting the most important news stories of the entire insurance industry to over 43,000 subscribers from over 30 countries. INSURANCE-LETTER is a service without any subscription fee from ACINA Ltd.. -- If your newsletter is not formatted correctly, you can read it online at http:///www.insurance-portal.com/ -- To subscribe, send an e-mail to insletter@aol.com with the word "subscribe", or call 888.282.1765, or subscribe online at www.insurance-portal.com . -- To unsubscribe send an e-mail to insletter@aol.com with the word "unsubscribe." Click here for more information. |
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1. TRIAL LAWYERS SAY INSURERS, NOT LEGAL SYSTEM, CAUSE DOCTORS' WOES
WASHINGTON, Jan. 2 /PRNewswire/ -- The following is a statement by Mary E. Alexander, President of the Association of Trial Lawyers of America: "The insurance industry has too much control over America's health care system. Insurers place profits over people and threaten the livelihood of America's doctors. Big insurance companies decide whether patients get the treatment they need, how much to pay doctors for each visit, and how much to charge doctors for medical malpractice insurance.
"The insurance industry itself admits that caps on damages in medical malpractice cases don't lead to lower insurance rates for doctors and rates are going up everywhere - even in states that have caps. It's unfair to ask patients to give up their legal rights so the insurance industry can make higher profits. Insurance companies should put people before profits." (www.atla.org) Back to Top
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2. BREAKDOWN OF INSURERS' PAYOUT TO J.P. MORGAN DETAILED
NEW YORK, Jan 2 (Reuters) - Eleven insurers are set to pay J.P. Morgan Chase & Co. Inc. (NYSE:JPM) about $568 million on surety bonds they issued to Enron Corp., under a settlement agreed on Thursday. That is almost 60 percent of the $965 million J.P. Morgan claimed it was owed by the insurers.
The list below describes, in millions of dollars, the initial terms of the settlement and the ultimate amount the insurers say they will pay, taking into account J.P. Morgan's offer to buy the insurers' rights to reclaim money from Enron at a rate of 13 cents on the dollar.
INSURER BEFORE FINAL SETTLEMENT
Travelers Property $159.6 $139
Chubb Corp. $110.2 $95.8
Kemper Insurance $93.7 n/a
Fireman's Fund (Allianz) $92.3 n/a
St. Paul Cos $80.4 $70
CNA Financial Corp $46.7 $40.7
Safeco Corp. $33.2 n/a
Hartford Financial $24.5 $21
Liberty Mutual $13.4 less than $12
TOTAL about $654 about $568
n/a = Not available (Note: The settlement involved 11 units of nine insurers) Back to Top
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3. UNITED KINGDOM HOME INSURER WARNS "DIRTY" BOMBS NOT COVERED
LONDON, Jan. 3 (Reuters) - The UK's biggest home insurer on Friday said it was reminding policyholders they were not covered for chemical, biological and nuclear attacks in light of government warnings Britain may face such threats. Norwich Union said it was the first British home insurer to give policyholders a detailed reminder of what they were covered for in the post-Sept. 11 world.
"People are beginning to wonder what happens if someone flies a plane into Sizewell (nuclear power station) and there's a radiation leak," a Norwich spokesman said of the firms' customers, who make up a fifth of all British homeowners. Norwich, part of top UK insurer Aviva Plc (AV.L), said renewal documents sent out since mid-2002 reminded householders their home and content policies had never entitled them to a payout for the effects of a chemical, biological or nuclear attack or accident.
Before Christmas, a senior British government source warned that sooner or later a militant group would probably launch some kind of successful terror strike against Britain. Norwich Union's domestic policyholders are able to claim for damage caused by a conventional bomb. Acts of war are traditionally excluded from home insurance policies. Insurance premiums for public buildings have near doubled in Britain since the Sept. 11 attacks and many insurers in the United States have dropped commercial cover for terror attacks.
In Australia, the government has introduced legislation to set up a pooled reinsurance scheme to cover property owners and insurers from the impact of aircraft, biological and chemical attacks. Nuclear attacks are not covered by the plan. President George W. Bush has signed legislation providing federal backing to ensure insurers provide cover for terror attacks like those of Sept. 11. Back to Top
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4. NEW YORK TIMES SAYS BUSH TO PROPOSE CHANGES IN MEDICARE PLAN
NEW YORK, Jan. 3 (Reuters) - With the new Senate majority leader as a powerful ally, President Bush will propose long-term changes in Medicare later this month when he urges the U.S. Congress to provide prescription drug benefits for the elderly, The New York Times reported on Thursday. Administration officials said Bush's vision for Medicare closely resembled proposals advanced in the last three years by Sen. Bill Frist, the Tennessee Republican who is to become majority leader when Congress convenes on Tuesday, The Times said in a report on its Web site.
Though White House officials were still working out details, Bush, like Frist, has said he wants to foster competition between the original fee-for-service Medicare program and private health plans, the newspaper said. Such changes could eventually make Medicare look more like private insurance. In the long-running debate over a Medicare prescription drug benefit, Democrats have supported more expensive proposals that would require the government rather than private insurance companies to pay for medicines prescribed to seniors. Back to Top
5. HEALTH INSURERS PAN PENNSYLVANIA MEDICAL MALPRACTICE PROPOSAL
WASHINGTON, DC, Jan. 2 - Following
is a statement of Health Insurance Association of America
president Donald Young, MD, regarding Pennsylvania's proposed
response to high medical malpractice insurance premiums:
"Everyone feels the effects of high medical malpractice
premiums, and we need to look for real solutions. Proposals to
fund a short-term fix to the problem with a new tax on health
insurers fail this test. American workers and their health
insurers already pay for the high cost of medical liability
lawsuits, including the cost of unneeded tests and procedures.
Where is the equity in asking them to pay again?
"In addition, the proposal penalizes prudent insurers.
Surplus isn't excess profit; it's the assets the regulators
require a company to hold to pay for unexpected future costs.
Moreover, depending on how the legislation defines surplus, this
proposal could result in an accounting nightmare. Companies doing
business all over the country do not segregate their surplus by
state or by type of insurance. Attempts to tax these required
surpluses could have unintended adverse consequences on the
financial solvency of insurers in Pennsylvania and beyond.
"We applaud Governor-elect Rendell's willingness to address
the problem of high medical malpractice premiums, but we are
disappointed that he has already taken the proper remedy - caps
on excessive awards for non-economic damages - off the table.
Given this unwillingness to tackle the root of the problem, we
are concerned that, if enacted, this proposed short-term fix
could make the problem worse by becoming a long-term subsidy paid
by private insurance subscribers.
"Therefore, while we agree that Pennsylvania physicians need
short-term relief, we oppose the flawed and inequitable method
the governor-elect has proposed for financing this relief." Back to Top
6. AMERIGROUP TRADES ON NEW YORK EXCHANGE; COMPLETES FLORIDA HEALTH PLAN BUY
VIRGINIA BEACH, VA, Jan. 2 /PRNewswire-FirstCall/ -- Amerigroup Corporation today announced that it will begin trading on the New York Stock Exchange (NYSE) on January 3. Amerigroup Chairman and CEO Jeffrey McWaters and senior management will ring the Exchange's opening bell on the company's first day of trading on the Big Board. The company will be the first in 2003 to list on the Exchange and will trade under the stock symbol "AGP." McWaters also announced that Amerigroup has completed its acquisition of Physicians Healthcare Plans, Inc. (PHP), effective January 1, 2003, adding approximately 190,000 members in Florida. Amerigroup is now one of the State's largest HMOs serving the Medicaid and Florida Healthy Kids (SCHIP) populations. It is anticipated that the acquisition of PHP will add approximately $300 million of annualized revenues, bringing Amerigroup's revenue run rate to more than $1.5 billion. As previously announced, the Company anticipates that its EPS in 2003 will grow by 20 percent over 2002, plus an additional $0.25 to $0.30 per share related to its acquisition of PHP. Amerigroup Corporation is a multi-state managed health care company focused on serving people who receive health care benefits through public-sponsored programs including Medicaid, SCHIP, and FamilyCare. ( www.amerigroupcorp.com ) Back to Top
7. TORT REFORM PROPOSALS SHOULD BE TIED TO MANDATORY PREMIUM DISCOUNTS FOR PUBLIC GOOD, SAYS POLICYHOLDERS
Friday January 3, 4:04 pm ET AUSTIN, Texas, Jan. 3 /PRNewswire/ -- The radical pro-insurance agenda of tort reform set forth by the Bush administration only benefits big insurance interests and, in its current form, will not serve to benefit small business, doctors or the average citizen, says Policyholders of America ("POA") a consumer advocacy group with more than 450,000 American families in its membership. Instead, POA urges the Bush administration to tie a corresponding 60% mandatory reduction in medical malpractice and other premiums to any tort reform measure contemplated.
In the past, tort reform was "sold" to the public as a mechanism to lower prices and insurance rates. It failed miserably and skyrocketing premiums prove it. In states like Texas where then Governor Bush successfully passed tort reform, Texans pay the highest rates in the country. Any legislation for further tort reform, both at the Federal and State level, should carry with it language that mandates rate discounts that better represent any caps or limitations on punitive and other non-economic damages.
To pass legislation without such a mandate is an egregious mistake. If additional tort reform results in dramatically reduced risk and liability, Americans should benefit from a corresponding discount in premiums. Otherwise, tort reform will be just another bail out for the insurance industry at the expense of the average taxpaying American. Back to Top
8. WELLCHOICE PRESIDENT/COO RESIGNS
Friday January 3, 2:16 pm ET NEW YORK, Jan 3 (Reuters) - WellChoice Inc. (NYSE:WC - News), a New York health insurance company, on Friday said President and Chief Operating Officer David Snow Jr. resigned after three years with the Blue Cross and Blue Shield provider. In response, the board of directors reappointed Chief Executive Michael Stocker to the additional position of president. Stocker, who last month revealed he has prostate cancer, will continue to run the company on a daily basis, WellChoice said. Snow, who is leaving to pursue other interests, joined the company in 1999 as executive vice president and COO responsible for all of the company's operations. "We are grateful for Dave's efforts on behalf of WellChoice, especially over this past year as we completed our conversion to for-profit status and took the company public," said Stocker in a statement. Back to Top
9. HILB, ROGAL, HAMILTON COMPLETES MERGERS WITH THE FREBERG GROUP
RICHMOND, VA, Jan. 2 Hilb, Rogal and Hamilton Company (NYSE:HRH), the worlds tenth largest insurance intermediary, said it has completed the previously announced mergers with the Freberg group of companies (Freberg) effective January 1, 2003. Freberg has seven offices in three states, Colorado, Wyoming and Texas, revenues in excess of $10 million, and employs approximately 65 insurance professionals. Terms of these combination Common Stock and cash transactions were not disclosed. (www.hrh.com)
10. MOODY'S CONFIRMS PERFORMANCE RATINGS OF LLOYD'S SYNDICATES
LONDON, Jan. 2 -- Moody's
Investors Service today confirmed the B- Below Average
performance ratings of syndicates 839 and 44, Trenwick Managing
Agents. The outlook for both ratings is stable. The performance
ratings of syndicates 839 and 44 were placed under review for
possible downgrade in October 2002. With regard to syndicate 839,
Moody's said at the time that, despite the progress made by
Michael Watson and his management team, there was uncertainty
over the extent and nature of the syndicate's capital backing for
2003. Trenwick at that time was negotiating with banks in respect
of the renewal / replacement of the $230m LOC facility which
supported their Lloyd's underwriting for 2002. Furthermore, other
sources of capital support for syndicate 839's 2003 underwriting
were being explored.
Since then, Trenwick announced that Berkshire Hathaway, via
National Indemnity Company, agreed to increase their provision of
capacity to syndicate 839 from GBP62.5m to GBP113m for 2003 via
special purpose syndicate 2750. GBP100m of this capacity is in
respect of the syndicate's aviation underwriting. Most recently,
Trenwick also announced that the relevant providers agreed to the
renewal of $182m of letters of credit supporting Trenwick's
Lloyd's underwriting. This renewal, together with the lodging of
additional funds of GBP76m by Trenwick, provide syndicate 839
with GBP215m of Trenwick capacity for 2003.
In light of the above, and with all relevant funds now lodged at
Lloyd's, the confirmation of syndicate 839's B- performance
rating reflects the ability of the syndicate to now trade in
2003, with an effective overall capacity of GBP328m (2002
capacity GBP262m). The rating reflects the improvement in
underwriting performance since the appointment of the current
management team, while recognizing that despite the recent
progress made, uncertainties remain over the syndicate's future
capital support.
With the relevant funds at Lloyd's having also been lodged in
respect of the 2003 underwriting of syndicate 44, which for 2003
is 79% backed by Trenwick, and with confirmation of its agency
for 2003, Moody's has also confirmed syndicate 44's B-
performance rating. The rating recognizes the syndicate's
non-strategic position within a general insurance group of this
small life syndicate of GBP4.5m, despite its consistently
positive historic performance.
Trenwick syndicates 839 and 44 are respectively composite and
life syndicates that both operate within the Lloyds of London
insurance market Back to Top
11. NEW YORK AGENTS GROUP RECOMMITS TO MARKET REFORMS
SYRACUSE, NY, Jan. 2 - The
legislative priorities in 2003 for the Independent Insurance
Agents Association of New York Inc. continue to concentrate on
badly needed insurance market reforms. With the Senate and
Assembly due to convene Jan. 8, the Syracuse-based trade
association is prepared to avert a deepening market crisis in New
York by continuing to aggressively pursue the solutions outlined
in its recently released 2003 Legislative Position Paper.
The focus in IIAANY's new Position Paper is on market stability,
auto insurance and workers' compensation. Severe problems with
each are manifested by exponentially rising premiums, the
complete or partial withdrawal of some insurers from certain
lines of business or geographic regions of the state and, when
coverage is available, the growing prevalence of having to settle
for less coverage when policies are renewed, often at a much
higher cost. A prime concern is the rapidly declining state of
the liability insurance market serving New York's building
contractors.
The association argues that Sections 240 and 241 of the state
Labor Law must be amended in order to replace the law's absolute
liability standard with a reasonable benchmark, such as that
found in Section 241(6). The standard in Section 241 (6) imposes
liability on contractors and property owners only when they are
found to be negligent in providing a safe place to work. However,
Sections 240 and 241 needlessly drive up construction costs and
impedes job growth by "absolutely" finding a contractor
or property owner liable when an employee is injured from a fall
at any height and for any reason. New York is the only state in
the nation with such an unfair standard. IIAANY's Position Paper
recommends that a more realistic definition of a "fall from
a height" be established while protecting the rights of an
injured construction worker to seek recovery for a legitimate
claim.
A good start to the new legislative session would also be
characterized by an early agreement to extend laws, which expired
in August 2001, governing auto insurance cancellations and
non-renewals, as well as rate adjustments. Those laws allowed
insurers to drop up to 2 percent of their auto customers within a
specified geographic territory for justifiable reasons and to
raise or lower their rates up to 7 percent without prior approval
of the state Insurance Department. The law governing
cancellations and non-renewals had been on the books for 20
years, while flex rating had been in effect since the mid-1990s.
Both were consumer-friendly. Since they expired, however,
insurers have increasingly placed severe restrictions on
accepting new policyholders. Additionally, passage of an
anti-fraud package that would reduce massive fraud in the state's
no-fault auto insurance system remains a top IIAANY legislative
priority.
In 2000 (the latest year for which data is available), New York
still ranked ninth highest in comparative workers' compensation
costs despite reforms enacted in 1996. As a result, IIAANY's
Legislative Position Paper calls for enacting additional reforms,
such as providing scheduled benefits for some injuries and
non-scheduled benefits for others, with a reasonable cap on
payments for permanent partial injury. Any discussion by
lawmakers over increasing workers' compensation benefits, IIAANY
contends, should include similar consideration of the
cost-management reforms the association and other members of the
state's business community support.
"It would be foolish for lawmakers to allow concerns over a
looming state budget deficit to prevent an early agreement on
these issues," said John Costello, IIAANY Chair of the
Board. "Legislative inaction on auto insurance and the Labor
Law issues, for example, have already produced a drag on New
York's economy that punishes all workers, motorists and
businesses. We need the Assembly leadership to come to the
negotiating table and reach agreements right away with the Senate
and Pataki Administration.
"The time for finger pointing and blaming the other party
for a failure to give New Yorkers a stable insurance market
should end now. We deserve better," he said. ( www.iiaany.org ) Back to Top
12. NEW WEBSITE FOR VOLUNTARY EMPLOYEE BENEFITS DEBUTS
BARRINGTON, IL - The Benefit Network, a national insurance marketing company focusing on employee-paid voluntary programs, and NORVAX, an Internet solutions provider for insurance agents, announce a new web site,1st-Supplemental-Health-Insurance.com, in which local independent agents and brokers can get leads from businesses searching for supplemental insurance programs. The site is designed to provide clients, independent insurance agents and agencies with information on what to look for when selecting voluntary programs.
A personalized web presence for voluntary plans and other affiliate programs are offered to create a privileged relationship for participating agents and their clients. Through this site, agents can register to access sales and marketing tips and innovative web tutorials and web based PowerPoints that educate prospects on the value of supplemental plans. The national site lets agents service inquiries in their local area and collect commissions regardless of which carrier that they currently are registered. Leads are offered on an exclusive basis based on the zip code of the inquiry. (www.thebenefitnetwork.com) Back to Top
13, IIABAS NATIONAL LEGISLATIVE CONFERENCE SET FOR APRIL 2-4
ALEXANDRIA, VA, Jan. 2The Independent Insurance Agents & Brokers of Americas (IIABAs) 27th Annual National Legislative Conference, the insurance industrys largest and most effective legislative gathering, will be held April 2-4 at The Capital Hilton in downtown Washington, DC. The event will bring hundreds of independent insurance agents and brokers to the nations capital during the critical early months of the much-anticipated 108th Congress. Lawmakers will be debating numerous issues shaping the future of the independent agency system and the insurance industry as a whole, including insurance regulatory modernization, tort reform and privacy issues.
Highlights of the Conference will include an in-depth issues briefing session; the annual IIABA Congressional Reception; appearances by numerous high-profile political speakers discussing important insurance and national issues confronting lawmakers and agents in Washington, D.C.; and hundreds of meetings on Capitol Hill between IIABA agents and brokers and their elected representatives.
Past National Legislative Conference speakers include the previous three presidentsBill Clinton, George Bush and Ronald Reaganand the last three Speakers of the Housecurrent Speaker Dennis Hastert (R-Ill.), and former Speakers Newt Gingrich (R-Ga.) and Tom Foley (D-Wash.). This years National Legislative Conference speakers will be announced as confirmations are received. For copies of the National Legislative Conference registration and hotel reservation forms, visit www.independentagent.com and select the "Events and Conferences" link. Back to Top
14. NAMIC TESTIFIES ON OHIO CREDIT-BASED INSURANCE SCORES DRAFT
INDIANAPOLIS, Jan. 2 -- The National Association of Mutual Insurance Companies (NAMIC) strongly supported the right of insurers to use credit information in making underwriting and rating decisions, in testimony before an Ohio Department of Insurance hearing Monday in Columbus, OH. "Credit-based insurance scoring has been shown to be a strong predictor of insurance loss, allowing companies to more accurately underwrite and rate their business," testified NAMIC's State Advocate Joe Thesing. "As a result of credit based insurance scoring, many companies affirm that they can write more business with greater confidence, and most policyholders directly benefit realizing better rates and more choices in the marketplace."
Thesing and other industry advocates presented testimony at a hearing on draft rule 3901-1-55 regarding the use of credit history and credit-based insurance scores. The hearing record will remain open until Jan. 9, 2003. Newly appointed department director Ann Womer Benjamin is expected to recommend a final rule after reviewing all comments submitted before the deadline.
"NAMIC commends Dan Kelso of the Ohio Insurance Institute and other industry advocates for their leadership in addressing industry concerns with the draft rule," Thesing said. Thesing called particular attention to the unprecedented agreement reached in an insurance scoring model act recently adopted by The National Conference of Insurance Legislators (NCOIL). "Passage of the model was the culmination of months of drafting and negotiating to create a proposal that was endorsed by all the national property/casualty trade associations and the agents associations, which is unprecedented."
The NCOIL model and the Department's draft rule mirror each other in many significant ways. "Both proposals contain "sole use" restrictions for both rating and underwriting," testified Thesing. "Both provide consumer disclosure in the form of initial disclosure that credit is being used and disclosure in the case of an adverse action. And, both address concerns expressed by agents regarding consumer requests to be re-rated and re-underwritten if their credit situation changes. However, we believe, the NCOIL model more clearly annunciates the obligations and rights of both consumers and insurers and, therefore, strikes a better balance between consumers rights and protecting the rights of insurers to utilize this valuable tool," testified Thesing.
"We respectfully recommend that the Department strike the current language in draft rule 3901-1-55 and replace it with all language contained in the NCOIL model act regarding the use of credit information in personal insurance," testified Thesing. "Because of the strong advocacy provided by NAMIC and others, the Institute is hopeful the Department will adopt a reasonable and balanced rule," said Dan Kelso, President, Ohio Insurance Institute. Thesings testimony is at www.namic.org/pdf/OHCreditScoreRuleTestimony.pdf Back to Top
15. DATABASE TO HELP INSURERS COMPLY WITH RULES ON SANCTIONS, EMBARGOES
JERSEY CITY, NJ, Jan. 2 ¾ Insurance Services Office, Inc. (ISO) will assist property/casualty insurers in complying with U.S. economic and trade sanctions through a new service from the ISO ClaimSearchÒ all-claims database. ISOs optional service, available to insurers claims departments through ISO ClaimSearch, will screen claims submitted by insurers to help them ensure transactions involving target countries and/or "blocked persons" are not completed.
The Office of Foreign Assets Control (OFAC) of the U.S. Department of the Treasury administers and enforces economic and trade sanctions, based on U.S. foreign policy and national security goals against targeted foreign countries, terrorists, international narcotics traffickers and those engaged in activities related to the proliferation of weapons of mass destruction.
"Our customers have requested us to help them comply with U.S. government sanctions programs. We are now working to develop the capability to check claims information in the ISO ClaimSearch system to identify organizations or individuals that may be on the OFAC lists," said Richard Boehning, senior vice president of ISO. ISO expects to introduce the service in the first quarter, he added.
U.S. sanctions not only target specific countries and their regimes but also their parastatal organizations, front companies, high-ranking officials and other agents worldwide. OFAC has identified and named numerous foreign agents and front organizations, as well as terrorists and narcotics traffickers, as "specially designated nationals and blocked persons" with a master list of over 5,000 variations on names of individuals, governmental entities, companies and merchant vessels located around the world.
All U.S. citizens and permanent residents, companies located in the U.S., and overseas branches of U.S. companies come under OFACs jurisdiction. All U.S. insurance companies and U.S. citizens and permanent resident aliens who are employees, officers or directors of U.S. or foreign insurance companies may be held accountable for violations of sanctions.. Depending on the program involved, criminal violations of the statutes administered by OFAC can result in corporate and personal fines of up to $1 million and 12 years in jail. OFAC also has authority to impose civil penalties. ( www.iso.com ) Back to Top
16. NORTH CAROLINA BANK COMPLETES BUY OF UWHARRIE INSURANCE GROUP
TROY, NC, Jan. 2 /PRNewswire-FirstCall/ -- First Bancorp (NASDAQ:FBNC), the parent company of First Bank and First Bank Insurance Services, Inc.., announces today that it has completed the acquisition of Uwharrie Insurance Group, Inc., a property and casualty insurance agency located in Troy. With eight employees, Uwharrie Insurance Group serves approximately 5,000 customers in Montgomery and neighboring counties. ( www.firstbancorp.com ) Back to Top
17. SUN LIFE FINANCIAL ANNOUNCES MERGER OF TWO NEW YORK SUBSIDIARIES
WELLESLEY HILLS, MA, Jan. 2 /PRNewswire/ -- Sun Life Financial said that, as of December 31, 2002, it has completed the merger of two of its subsidiaries, Sun Life Insurance and Annuity Company of New York ("Sun Life NY") and Keyport Benefit Life Insurance Company ("Keyport Benefit"). The merger is designed to streamline Sun Life Financial's operating structure in the U.S. and has no effect on the existing rights and benefits of policyholders' or contract holders' from either company. Sun Life Financial Services of Canada Inc. (NYSE:SLF), acquired Keyport Life Insurance Company and its subsidiary, Keyport Benefit, from Liberty Financial Companies, Inc. in 2001. The merged company will be known as Sun Life Insurance and Annuity Company of New York and will carry on the business formerly conducted by both Sun Life NY and Keyport Benefit.. ( www.sunlife-usa.com ) Back to Top
18. TENET GETS DOJ SUBPOENA ON MEDICARE PAYMENTS
SANTA BARBARA, Calif. Jan. 3 (Reuters) - Hospital chain Tenet Healthcare Corp. , whose billing practices are being investigated by the U.S. government, said late on Thursday it received a subpoena from the Department of Justice demanding information on certain Medicare payments. The number two U.S. for-profit hospital operator, which has been under scrutiny since October when two of its doctors were accused of performing unnecessary heart surgeries, said the subpoena requests documents from Tenet and 19 hospitals owned by its subsidiaries.
At issue are Tenet's past high volume of so-called outlier charges to the Medicare health plan for the elderly. The payments are made to help hospitals defray the extra cost of treatment involving unusual or higher than average patient costs -- usually very ill patients. Tenet Healthcare, which through its subsidiaries owns and operates 114 hospitals in 16 states, has maintained that it did not break the law regarding the Medicare outlier payments. "Given the scrutiny and controversy regarding outlier payments, it is not surprising that the Justice Department is interested in reviewing the matter," said Christi Sulzbach, Tenet's chief corporate officer and general counsel. Tenet said 15 of the 19 hospitals that received requests are located in California, with the rest in Texas, Pennsylvania and Louisiana. Tenet said it would cooperate with the Department of Justice requests.
Tenet has suffered a host of problems during the second half of 2002, including the questions over outlier payments, the two doctors at its Redding, California medical center, the resignation of two top executives, a dissident shareholder lawsuit and union accusations that it exposed patients to higher risks of injury and death from dangerously low staffing levels. The company disclosed in early November that U.S. regulators plan to audit payments made to its hospitals to determine whether it overbilled the federal Medicare program. The company warned on December 3 that its fiscal 2003 and 2004 profits would fall short of estimates as Medicare cuts payments to high-cost hospitals. The Centers for Medicare & Medicaid Services, which administers the Medicare program, said it would "clamp down on hospitals for overcharging for complex cases". Back to Top
19. AETNA REACHES TWO-YEAR AGREEMENT WITH VANGUARD HEALTH SYSTEMS
Friday January 3, 3:07 pm ET PHOENIX, Jan. 3 /PRNewswire/ -- Aetna and Vanguard Health Systems' Arizona Region announced today that they have reached a two-year agreement through which Vanguard facilities will provide services for Aetna members in the state of Arizona. Aetna's Arizona network includes 1,240 primary care physicians, 4,767 specialists and 49 hospitals. Back to Top
20. CAPITAL BLUECROSS WINS FIRST ROUND OF COMPETITION WITH FORMER PARTNER
Friday January 3, 10:20 am ET First Year of Competition Between Capital BlueCross and Highmark Ends With Capital BlueCross Winning More Than 60 Percent of Former Joint Business. HARRISBURG, Pa., Jan. 3 /PRNewswire/ -- Capital BlueCross CEO James M. Mead today announced that the books have closed on the first calendar year of competition between former partners Capital BlueCross and Highmark -- and a strong majority of the two companies' former joint customers have chosen Capital BlueCross as their health insurance provider. As of Jan. 1, Capital BlueCross has won 60.5 percent of the market formerly held by the two companies together. More than 80 percent of the group accounts formerly insured jointly chose Capital BlueCross. And Capital BlueCross also has won significant new business -- surpassing even its own new-business goals. Competition between the two companies began April 1, 2002. Nearly 95 percent of the former joint members have made their selection.. Back to Top
21. INSURANCE NEWSLINK ARTICLES
INSURANCE-LETTER has arranged with INSURANCE NEWSLINK to help bring a global perspective of the news located at the end of each Monday and Thursday daily newsletter. INSURANCE NEWSLINK is a worldwide, strategic business and information technology intelligence database comprising over 15,000 articles commencing July 1993. To view any of the articles below click here http://www.insurancenewslink.co.uk/Articles/ExternalView?u=7
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30 countries.
·
BENEFITS BUSINESS Magazine - The publication read by 50,000 Benefit
Advisor professionals quarterly.
·
N.A.P.E.S./eSI - 1,400
Members helping to move Worksite Marketing to the front of the
distribution line. www.worksite.net
·
INSURANCE MEDIA ASSOCIATION - The premier network for professionals engaged in
insurance media, www.insurancemedia.net
·
ACINA.TV & ACINA.NET - Coming in 2003 to transform the way insurance
professionals meet and share information.
· www.insurance-portal..com - The Most Useful Site On The
Internet For Insurance Professionals (due to be completely
revised on 02/01/03).
9864 Burton Drive, Suite #101, Twinsburg, OH 44087 - 888-282-1765 - 330-425-3439 - fax wpodgurski@aol..com www.insurance-portal.com
INSURANCE-LETTER'S TOP 25 NEWS STORIES OF
2002
INSURANCE-LETTER'S 2002 LIST OF THE 100 MOST POWERFUL PEOPLE IN
THE INSURANCE INDUSTRY - NORTH AMERICA