Geisinger must pay back customers including interest.
Geisinger Health plan rejected health insurance claims for things that should have been covered, with many of the wrongful denials involving mental health care and substance abuse treatment, the state insurance department said.The insurance department is requiring Geisinger Health Plan to reprocess claims and pay back customers for wrongly-rejected claims, including interest.
“The Insurance Department’s top priority is consumer protection within the marketplace, and these examinations are an opportunity for the department to ensure that companies are held to high standards and consumers are receiving the benefits to which they are entitled,” Michael Humphreys, the acting state insurance commissioner, said in a news release.
Geisinger Health Plan in a written statement said it’s “in the process of identifying next steps with the Insurance Department, however many of the issues identified during the examination have long been addressed or corrected.”“We appreciate the opportunity to partner with the Insurance Department on opportunities to improve, which is very much aligned with Geisinger’s mission to make better health easier for the communities we serve,” Geisinger said.
“Geisinger will report on restitution as part of their quarterly reporting to the department. As some of the issues identified in these exams are systemic in nature, it may take some time for the companies to identify all claims and members impacted,” the department said in an emailed response to questions.
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