Thursday, November 3, 2005

Subsidiary of Nashville health insurer accused of wrongdoing in Rio Grande Valley

The Brownsville Herald reports in this article that across Texas' Rio Grande Valley new customers of Texas HealthSpring, a subsidiary of Nashville-based NewQuest Health Solutions LLC, are alleging that they were fraudulently enticed away from Medicare and to the private insurer. Texas HealthSpring has temporarily suspended the issuance of new policies there.

"The program serves primarily senior citizens and the disabled, Texas HealthSpring documents show."

"[Dr. Lorenzo] Pelly and some of his patients reported that Texas HealthSpring representatives visited several senior centers here to recruit clients. He said he plans on signing off of the company’s network."

"Pelly believes Texas HealthSpring representatives told some of his patients that they were Medicare officials, and the papers they were signing were related to their Medicare not to a private insurance company."

"Maribel Benavides found out her elderly father, who she said does not possess the capacity to make decisions about his health insurance since suffering a stroke, changed to Texas HealthSpring."

"Suddenly, his usual doctor was not covered under his new insurance, and neither was the cost of his treatment for liver cancer."

"The company told employees Friday to no longer sell policies in the Valley until further notice."

"The primary problem, according to some local health providers, is not the company, rather that patients seem unaware of changes brought by their new plan. Some can no longer see their usual doctor and must select a provider from a new list."

Full article here

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