Insurers Accused of Withholding Criteria

From Reuters

New York Atty. Gen. Eliot Spitzer said health insurance companies had been withholding information from patients about how they decide which procedures are medically necessary, and threatened to punish them if they are not more forthcoming.

Spitzer’s office released results of a survey of insurers showing that nearly all health plans violated the law by failing to disclose the criteria they use to evaluate whether a medical procedure would be covered.

The New York Health Plan Assn., which represents insurers operating in the state, said health plans generally do a “good job providing clinical review information.”

It said it would work with the attorney general’s office to help plans raise compliance with the law.