Empire Blue Cross/Blue Shield, the largest nonprofit health insurer in New York, has been fined $1.1 million by the state's insurance regulators.
Among other things, Empire was charged with denying health coverage to certain patients:
Denying advanced chemotherapy and bone marrow treatments to some women with breast cancer, while approving treatments for others.The $1.1 million fine is the largest ever levied against a health insurer in the state of New York. Since the time of these infractions, Empire has seen the number of policyholders reduced by approximately 50 percent (to 4.8 million).Denying in vitro fertilization procedures to some while approving the procedure for others.
Paying physical therapists for certain procedures, but denying payment to chiropractors for the identical procedures.
While Empire has positioned a new management team to recoup its losses, the fine should send a clear message to other carriers. The New York Insurance Department is expected to keep a close watch on Empire over the next three years.
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
On Feb. 1, 2024, two more legislators – John R. Carter (R-Texas) and Robert “Bob” Good (R-Va.) – co-sponsored the Chiropractic Medicare Coverage Modernization Act of 2023, bringing the co-sponsor total to 155, two more than the total achieved over the entire two-year congressional cycle in which identical legislation last appeared (2021-22).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
