Articles by Susan Heavey

State Regulators Back Strict Medical Ratio for Health Insurers

U.S. state insurance commissioners unanimously backed tough rules requiring health insurance companies to direct more of the premiums they collect to medical care, rather than corporate salaries and profits. Although the percentages are mandated in the new healthcare law, insurers …

Industry Worries As Regulators Decide on Critical Loss Ratio

A seven-month-long process for determining how much U.S. health insurers must spend on medical care comes to a head Thursday, amid fresh concerns that the rules will lead companies to desert some small-group and other niche markets. A key group …

House Report: Denials of Coverage by Large Health Insurers Up 49%

Coverage denials of individuals based on their medical histories by the nation’s top for-profit health insurance companies rose by nearly half in recent years, U.S. lawmakers said Tuesday. The findings raise questions about industry practices before a law to prevent …

State Regulators Develop Rule on Health Insurers’ Medical Spending

U.S. health insurers should be able to exclude most federal taxes, but not all, in calculating spending rates to meet new healthcare law requirements, an insurance advisory group has proposed. Under a draft plan released Thursday, insurers would be allowed …

Some Health Insurers Shifting Costs Ahead of New Loss Ratio Mandate

Some of the largest U.S. health insurers are changing their accounting practices to book administration costs as medical costs in an attempt to circumvent new industry reforms, according to a recent U.S. Senate panel’s report. Under the healthcare law passed …

Winners, Losers in Obama Health Proposal

Health insurers, makers of brand-name drugs and generic drugmakers are among the industry players who see further pressure in President Barack Obama’s health care proposal released Monday. The White House plans to hold a summit with Democratic and Republican congressional …

FDA Says Changes Needed in Review of Medical Devices

Food and Drug Administration staff said they face difficulties in reviewing certain medical devices, hurdles that may call for additional regulations and authorities, even as the industry defended the current approval process. At a public meeting Thursday, held to discuss …

Democrats Seize on Wellpoint’s 39% Rate Hike to Renew Reform Effort

Health insurer WellPoint Inc. defended its rate hike of up to 39 percent for certain California customers as Democrats latched onto the increase to press their case for overhauling the U.S. healthcare system. The controversy comes as Democrats struggle for …

Obama’s Budget Shows Only Modest Changes in Health Reforms

The Obama administration’s latest spending plan calls for modest changes to the U.S. health care system but does little to incorporate sweeping moves called for Democrats’ larger plan to increase access and cuts costs. In releasing his fiscal 2011 budget …

White House Budget Takes Small Steps on Health Care Reform

With plans to pass sweeping health care reform stalled in Congress, the White House is targeting smaller efforts to improve the nation’s health care system, such as increasing use of cheaper, generic medicines and boosting electronic medical records. The Obama …