Senate Committee Targets Claim Rejections By Health Insurers

The News Journal: A Senate committee has sent letters to two more Delaware insurance companies that have denied coverage for nuclear stress tests, imaging tests that are used to identify heart-attack causing arterial blockage. The letters were sent on Friday to Aetna and Coventry Health Care. "A similar call for detailed information on the tests was sent last month to Blue Cross Blue Shield of Delaware as the Senate panel gears up an investigation of preauthorization claim rejections by insurers ..." Sen. Jay Rockefeller, chairman of the Commerce Committee said "Denying medically necessary services to patients showing signs of serious heart disease is not tolerable."

However, MedSolutions, a Tennesse-based contract reviewer used by most of the insurance companies being investigated by the Senate panel and others in the insurance industry, "say doctors stand to gain financially because they perform the tests in their offices, often using equipment they own. Inappropriate tests are expensive and unnecessarily expose patients to doses of radiation, critics have said" (Starkey, 4/17).

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