Sunday, October 25, 2009
Shameless Corporation of the Week Award
This weeks Shameless Corporation Award is shared by Horizon Blue Cross Blue Shield of New Jersey and the company it contracts with to manage claims, Magellan Health Services. Magellan is notorious for denying benefits to the Blue Cross patients. In this case, a young woman who was a victim of date rape was unable to receive mental health benefits even though she was insured. Magellan stopped paying for her mental health visits with a psychologist for no reason. They just said "no"and appeals were met with further denial.
Lois Gorwitz is a psychologist who worked for Magellan for two years as a claims reviewer and she said the culture and pressure from supervisors was to deny claims. Gorwitz said the company denied claims because they are in the business to make money. She quit because she was uncomfortable with the pressure to deny valid claims. Magellan is expecting 2009 profits of $210 million, exceeding predictions.
Horizon Blue Cross Blue Shield is the states largest insurer and they posted $5.5 Billion in sales last year. To see more about EverythingHealth's Shameless award recipient, and the college student who was denied benefits, watch this Vid.
Posted by Toni Brayer, MD at 9:02 PM