Mark P. Scherzer Health Insurance Law Blog on Lawyers.com

Mark Scherzer testified on June 8, 2009, at a hearing held by the New York State Assembly Insurance Committee in Albany, in support of a bill that would reinstate the ability of the State Insurance Department to review and approve certain health insurance premium rate increases prior to their taking effect.  Representing New Yorkers for Accessible Health Coverage, Mark pointed out that if insurers overcharge, individuals and small businesses might be forced to drop coverage, and they have no effective remedy at their disposal to contest the overcharges.   Insurers, on the other hand, can always sue the Insurance Department if an appropriate rate increase is denied.  The risks to consumers are therefore higher from lack of regulation than are the risks to insurers from having to live with regulation.  Consumers, Mark said, “need the protective power of the state to give them a fighting chance when facing huge and powerful institutions like insurers.”

In a report issued on the day of the hearings, the Insurance Department identified tens of millions of dollars in overcharges by health plans under the current “file and use” system.  Insurers have failed to police themselves effectively; they do not voluntarily correct the majority of those overcharges.  By the time the State is able to act, it is often too late for the people who have gone without coverage.  They may already have been damaged by foregoing necessary medical care. The press release announcing the report, including a quote from Mark, may be obtained at http://www.ins.state.ny.us/press/2009/p0906081.htm