I hadn’t heard that algorithmic health care decisions had been ruled illegal. If the company were doing that, couldn’t they be considered a criminal enterprise?
They definitely made an exception for those states. The same thing happened with the announcement of that Blue Cross branch that was going to stop paying for anesthesia after an arbitrary time limit. They made an exception for Connecticut because they passed a law making it illegal.
Given how businesses work they probably didn’t stop doing it they probably just toned it down a little bit. Like instead of “deny 50% of coverage by default” they set it to like “deny 43%”.
Only ruled illegal in a couple of states. And no, doing some illegal things doesn’t make you (under the law) a criminal enterprise. That’s a term used for operations whose fundamental business is crime, as opposed to just employing some illegal methods in the pursuit of legal activities.
(This is not, remotely, an argument against much, much stronger penalties for companies that do illegal shit. If the fine is less than the profit then its just a cost of doing business).
You can do deeply unethical things that are legal, such as delay deny defend. If only insurance stopped there it would be a great improvement. It’s more likely they cross the line of what’s legal as long as there’s a chance of profit, even when penalties apply.
I hadn’t heard that algorithmic health care decisions had been ruled illegal. If the company were doing that, couldn’t they be considered a criminal enterprise?
Presumably they stopped doing it in those states, or it’s being appealed or something.
Also possible they’re just ignoring a court order, I suppose, but that seems unlikely
They definitely made an exception for those states. The same thing happened with the announcement of that Blue Cross branch that was going to stop paying for anesthesia after an arbitrary time limit. They made an exception for Connecticut because they passed a law making it illegal.
Given how businesses work they probably didn’t stop doing it they probably just toned it down a little bit. Like instead of “deny 50% of coverage by default” they set it to like “deny 43%”.
As long as it flies under the radar right?
Only ruled illegal in a couple of states. And no, doing some illegal things doesn’t make you (under the law) a criminal enterprise. That’s a term used for operations whose fundamental business is crime, as opposed to just employing some illegal methods in the pursuit of legal activities.
(This is not, remotely, an argument against much, much stronger penalties for companies that do illegal shit. If the fine is less than the profit then its just a cost of doing business).
I knew it was a fantasy when I wrote it. I mean, obviously they pay more for lawyers than anything else.
Just amazing how far they can stretch the law without it snapping back on them.
Oh, so, insurance companies are “criminal enterpriseS”, plural. Gotcha.
You can do deeply unethical things that are legal, such as delay deny defend. If only insurance stopped there it would be a great improvement. It’s more likely they cross the line of what’s legal as long as there’s a chance of profit, even when penalties apply.