HCR: A Silver Lining Is Still Only Found in a Storm

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It’s said that every cloud has a silver lining. The “reform” of health care is a far cry from the tort reform this country so desperately needs, but there is an up-side. Abusive insurance company practices are about to come to a grinding halt. In this one sense, the practice of medicine will return to its rightful place, between the doctor and the patient.

A good part of what precipitated the health care reform bill was just such abuses. People who were canceled for pre-existing conditions — even when those conditions didn’t represent a major cost to the health insurance company — finally have retribution. Starting in September, rescissions will no longer be allowed, except in the case of fraud. And if an insurer wants to claim fraud, it must provide the affected customer at least 30 days’ notice for time to appeal.

Most of the healthcare protections and benefits are still years off. Rescission protection is so relatively rare that it’s a rather small bit of silver lining in exchange for all the increased costs and decreased benefits that insurance companies claim are necessary to pay for the impositions of fair coverage. Though it’s a small part of the population, it’s a vulnerable portion, in that rescissions don’t generally happen to people in a group plan. They are performed on individual plans, the people who pay the most and can least afford to lose the coverage OR fight back.

The times, they are a’changin’. We can find some solace in that at least a few things won’t be controlled by the whim of insurance companies anymore. In those aspects, doctors will now be able to prescribe what is best for their patients without fear that some insurance company clerk is going to override that treatment choice or end the treatment altogether by a predatory practice like rescission. Too bad that doesn’t begin to offset the decrease in pay for Medicare that has just slipped in. The cloud may have a silver lining, but it’s still a cloud; It’s about time to batten down the hatches. There’s a big storm headed this way.

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Medical Justice provides comprehensive support for challenges such as preventing frivolous lawsuits, addressing unwarranted refund demands, managing sham peer reviews, and safeguarding your online reputation. Our expert team assists with issues like defamatory reviews, medical board complaints, and notices of intent to sue.

We offer legal protection plansonline reputation management, and consultations for concerns that fall outside of membership coverage (such as board complaints, National Practitioner Data Bank reports, and negotiation on your behalf with patients seeking refunds), with suggested next steps to help you regain control. If you require more hands-on assistance, or if your need falls outside the scope of membership, we can often be engaged for further support. Contact us today to get started by scheduling a consultation with a member of our tea

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Jeffrey Segal, MD, JD
Chief Executive Officer & Founder

Jeffrey Segal, MD, JD is a board-certified neurosurgeon and lawyer. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country's leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

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