Thursday, July 8, 2010

Bennet: Denial of Health Care Due to One Penny Discrepancy Deplorable

Woman Threatened Denial of Coverage Over One Penny Prime Example of Why We Need to Stand Up Against Big Insurance Companies

Bennet Calls on Department of Health and Human Services to Ensure These Practices End

Washington, DC – After reports that a Colorado Springs woman was threatened that her coverage would be dropped due to a dispute over one cent, Michael Bennet, U.S. Senator for Colorado, today released the following statement calling for practices like these to end.

“It is unconscionable that an insurance company or a benefits administrator would drop someone’s coverage because she was a single penny short on her payment.

“This is a prime example of why we need to stand up and fight for Coloradans and all Americans. The insurance companies and those that administer health insurance have held all the cards for far too long. Without a second thought they are willing to drop us from our coverage when we need it most, come between us and our doctors and literally make life-and-death decisions based on a stray penny.

“No patient should have to wage a fight with insurance carriers while simultaneously fighting for his or her life against an illness.”

La Rosa Carrington, a single mother from Colorado Springs, is fighting leukemia, and Discovery Benefits, an employee benefits administrator in North Dakota, was terminating her health insurance benefits because she was one penny short on her premium payment. Click here for the full story.

In a letter to Secretary Kathleen Sebelius, Bennet called on the Department of Health and Human Services’ new appeals office to be more consumer-friendly and ensure something like this never happens again.

The full text of Bennet’s letter is included below.

Dear Madam Secretary:

As you know, the Patient Protection and Affordable Care Act included provisions that establish new consumer protections for patients to file grievances and appeals of their insurance company’s coverage or claims determination.

One Coloradan who has experienced firsthand the consumer abuses perpetuated by the insurance industry is La Rosa Carrington. Ms. Carrington is a single mother of two teenage daughters who lost her job in May, and she has leukemia.

After Ms. Carrington lost her job, she opted to stay on her employer’s health insurance plan, administered by Discovery Benefits – as allowed by COBRA law. Ms. Carrington did not receive a bill for the premium for her first month of COBRA coverage, so she calculated her premium herself. Her share came to $165.15 and sent a check in that amount to Discovery Benefits.

A month later, Ms. Carrington received a letter from Discovery Benefits informing her that she would be denied coverage because she had failed to pay the full amount of her premium – by one cent. While her benefits have now been reinstated after speaking to various representatives of the insurance carrier, no patient should have to wage a fight with insurance carriers while simultaneously fighting for his or her life against an illness.

As you work through the process of implementing health care offices of consumer protection and health insurance ombudsman programs as established in Section 2793 of The Patient Protection and Affordable Care Act, I encourage you to keep in mind the stories of Americans like La Rosa Carrington, who need a consumer-friendly, fair and effective appeals process to ensure that they do not lose their coverage when they need it most.

Thank you for your attention to this important issue.

Sen. Bennet

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