PAMED Negotiates Amendments to Harmful Insurance Fraud Bills
Three bills to combat insurance fraud that could have unintended consequences for physicians have been introduced in the state General Assembly. However, the Pennsylvania Medical Society (PAMED) has successfully negotiated amendments that would make these bills more fair.
House Bills 1750 and 2154 and Senate Bill 1181 would grant insurers new powers and protections but could harm physicians who have been unfairly identified as potentially engaging in fraud.
HB 1750 and SB 1181 would have provided absolute immunity to an insurance company for sharing information about providers with designated individuals and entities. PAMED negotiated an amendment that would require the state insurance commissioner to approve databases used by insurers to share such information.
HB 2154 and SB 1181 would have protected insurers unless they act with actual malice, rather than requiring them to act in good faith, but PAMED was successful in having this provision removed from both bills.
Both House bills are being considered by the House Appropriations Committee. The Senate bill has passed the Banking and Insurance Committee and is now in the Senate Appropriations Committee.
“There needs to be a fair balance between removing barriers that impede identification of possible insurance fraud and protection against false accusations and innuendos,” said PAMED President James Goodyear, MD, in a hearing before the House Insurance Committee in March.
Last Updated: 7/2/2010