WellPoint health ousts CFO over misconduct
Top executives at WellPoint Health Networks Inc. have requested and received the resignation of David C. Colby, the company’s chief financial officer. An investigation by external legal counsel concluded that Colby violated WellPoint’s code of conduct. The company noted in a press release that Colby’s violations were not of an illegal nature and were unrelated to WellPoint’s business. Wayne S. DeVeydt has been appointed executive vice president and CFO, effectively immediately.
Federal groups OK Pennsylvania payer merger
A proposed merger between Pennsylvania’s two largest health insurers has received approval from the Federal Trade Commission and the Department of Justice’s antitrust division. Critics of the transaction have argued that the merger between Independence Blue Cross and Highmark, Inc. would limit competition in the state’s insurance market. If the merger is consummated, the companies will form one of the nation’s five largest health insurers.
Bill to curb California health plan rates advances
Legislation that would require California-based health insurance companies to justify increases in plan rates and jumps in corporate profits has passed the state’s Assembly Appropriations Committee. The bill would monitor payers’ rates to ensure that no increases in co-payments, rates, or deductibles are “unfair or excessive.” Even plans that request increases of less than 5 percent would have to agree to full disclosure and provide proof of their spending on medical care, a press release issued by the Foundation for Taxpayer and Consumer Rights indicated.
Doctor, biller convicted for bilking Blues plan
A Detroit-based physician and biller have been convicted by a federal jury for a scheme to bilk Blue Cross Blue Shield of Michigan of $775,000 in false claims. The jury found Zack Brown, MD, and Davell Culberson guilty on 80 counts of healthcare fraud and conspiracy on accusations of submitting some 19,000 false insurance claims. The pair used recruiters to find BCBSM subscribers and promised them half of the payments from the fraudulent claims. An ongoing investigation into the scheme has resulted in 12 further convictions and 29 pretrial diversion and restitution agreements.