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Saturday, March 31, 2007
Ind. Law - Screening patients for alcohol-drugs may mean insurer won't pay their claims
Bryan Corbin of the Evansville Courier & Press had an interesting story this week about HB 1378. The story begins:
A woman who has a glass of wine at dinner trips and falls outside the restaurant.The hospital emergency room treats her broken ankle, but although she is insured, her health-insurance company won't pay the claim. The reason: A blood test showed she had alcohol in her system, even though she wasn't legally intoxicated. And that denial is perfectly legal.
Indiana lawmakers heard that Portland, Ore., example Thursday as they considered a proposal to change the law, so insurers cannot deny claims solely because patients test positive for alcohol or drugs.
Over one year, Deaconess Hospital in Evansville treated six patients who tested positive in alcohol-drug screenings, whose insurance companies later wouldn't pay their claims.
Those unreimbursed charges totaled more than $360,000, said Paul Swiz, manager of regional network services at Deaconess Health System in Evansville.
As a result, Swiz said, Deaconess
no longer conducts routine blood-alcohol screenings of trauma-room patients, so insurers won't deny payment. "It's sort of a Catch-22," Swiz told a state Senate committee Thursday.
The culprit is a 1947 law, the Uniform Accident and Sickness Policy Provision Law, which allows insurance companies to deny coverage if insured patients have alcohol or intoxicating substances in their systems when injured. Some insurance carriers ignore the 60-year-old law and pay anyway; others enforce it.
Posted by Marcia Oddi on March 31, 2007 04:06 PM
Posted to Indiana Law