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.  

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Comments: 2


my issue is in regard to the injustice that is performed when someone is harmed by a physician or company. this may very well be on the political side of your association. it is unjust for anyone to monitor my home watching one use the jon, shower, and dress. it is unjust to be stopped from pursuing any legal help. one can go from one lawyer to another only to give details that are used against you rather than helping you. you are physically disabled, being medicated and sick without going to a physician spending most of your time laying in bed stinking like garbage, eating very little, unable to get up and this goes on for years. If by chance, you get to a law office, you are told that statue of limitation has expired. this is unjust and i feel that your association and others who decide on what is best should take this into consideration. all of it, is against one's constitutional right. i feel that your association thinks little about the patient if this is how a person is treated. one has the right to be compensated for their injuries and losses. one has the right to know the truth of their medical condition, by a physician, instead of planning how to treat someone by tapping into phone lines and one's home. i can't be sure if the problem lies with the physician or the political end of your association. what i do know is that it is unjust!

anonymous at 5/17/2010 1:20:13 PM


my issue is related to neuro medicine and practices, as well as toxin related issues. i feel that your association debates more on protecting the physician then it does the patient. the reason i feel this way is because of a situation that happened 11 years ago with a neurologist and an emg. it took a year before anyone actually did an mri which indicated morton's neuroma disease. i was working, at this time, and before the mri was given walked around in severe pain and severe muscle spasms all through the night. this kept me up most of the night which then made me late for work the next day. i took a short-term leave to take care of the problem but was told to go to a psych-resource center while comp-services harassed me everyday stating that my pain was all in my head. i received numerous steroid injections from numerous podiatrist. a couple of days after the incident, i went to an emergency room only to be refused any testing and in fact these physicians jumped back when i stated when and how the pain began. i was told to go to the physician who performed the test. i left the ER room without treatment and then received a co-pay bill of $50.00. i don't feel, I should have to pay a co-op payment if my needs were not met. i tried to contact the physician but was told repeatedly by his secretary that he was busy with patients. i am then told, much later, that i had restless leg syndrome but in fact the tremmor in the legs were due to the medication i was given. my biggest issue is the fact that i am given a neuro medicine to treat my neuro condition but these medicines are also used for psychological purposes. so instead of being told the truth, i am treated as a person with psychological conditions. this is so unfair it sickens me. not only did i suffer with a neuro-muscular disability and had to persever the pain, i had to be characterized as a person with mental problems and had to be harassed at my work place. this was done without my pursuing any law suit.

anonymous at 5/17/2010 12:46:07 PM

Last Updated: 7/2/2010
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