California AG Office Launches Independent Inquiry into HMOs' Handling of Health Insurance Claims

News Release
September 03, 2009
For Immediate Release
Contact: (916) 324-5500
Print Version

Brown Launches Independent Inquiry into HMOs' Handling of Health Insurance Claims

Los Angeles - Attorney General Edmund G. Brown Jr. today announced that deputies in his office are launching an independent inquiry into how Health Maintenance Organizations review and pay insurance claims submitted by doctors, hospitals and other medical providers.

This investigation is prompted by reports that California's five largest health-insurance providers are denying insurance claims at rates of up to 39.6 percent.

"These high denial rates suggest a system that is dysfunctional, and the public is entitled to know whether wrongful business practices are involved," Brown said.

In the coming days and weeks, deputies will review records and will speak with individuals who have relevant knowledge of the issues raised.