Blue Cross sent California medics letters, together with the copies of health insurance applications of new policy holders. Included in the pre-existing conditions that Blue Cross wants divulged prior to signing up or else face cancellation of their policy was pregnancy.
Shannon Troughton, spokeswoman of WellPoint, which runs Blue Cross in California, said in an email reply to the San Francisco Examiner, "Enrolling an applicant who did not disclose their true condition will quickly drive increased utilization of services, which drives up costs for all members." She said physicians are not required to give in to their request, but they may volunteer information.
Dr. Richard Frankenstein, president of the California Medical Association, is not in favor of breaching the patient-doctor trust. "We're outraged that they are asking doctors to violate the sacred trust of patients to rat them out for medical information that patients would expect their doctors to handle with the utmost secrecy and confidentiality," Frankenstein said.
Frankenstein added if doctors will give in to Blue Cross' request, it might result to patients not disclosing to doctors conditions or symptoms that they fear might later present a problem for their health policy coverage and later on affect their health.
Blue Cross itself is under investigation by state regulators for issuing policies without scrutinizing the application and then later on canceling the coverage when costs go up. It was fined on March by the Department of Managed Health Care $1 million for canceling policies.
Blue Cross said it was not a new practice to ask doctors for information about their patients' medical backgrounds, but it is only now that the practice is being questioned. Troughton defended the data request that sharing of medical information within medical circles did not constitute breaching patient confidentiality because it fell under patient, treatment and operations guidelines. She added Blue Cross does not cancel all the time the coverage of policy holders with discrepancies on their applications. In some cases the company offers them another plan, Troughton said.
Because of doctors' complaint about the Blue Cross letters, the state Insurance Commissioner said it is studying the case. Commission spokesman Byron Tucker said he found the letter extremely troubling. tucker explained to the Los Angeles Times, "It really obliterates the line between underwriting and medical care. It is the insurer's job to underwrite their policies, not the doctors'. Doctors deliver medical care. Their job is not to underwrite policies for insurers."
