Monday, April 18, 2011

Transparency in government: UnitedHealth and S.B. 1274

Corporate health plan backing for S.B. 1274 became crystal clear on Friday. When the media needed a spokesperson on behalf of the bill, UnitedHealth offered up its local Honolulu lawyer.

UnitedHealth (or Evercare as they are known in Hawaii) could not have made their interest in the passage of S.B. 1274 clearer. The attorney they used is the same one who defends Evercare whenever a patient appeals to the external review panel the company's denial of medically necessary medications, treatments or services.

S.B. 1274 was recently amended to be retroactive to January 1, automatically dismissing all current cases. UnitedHealth is the defendant in eleven of twelve pending cases, so this amendment alone could be saving the company as much as $500,000.

The plaintiffs' attorney in all those cases is Honolulu lawyer Rafael del Castillo. Del Castillo only takes cases "on a contingency basis." That means he accepts no money from clients up front, even when actual hard costs are incurred for expert testimony. Del Castillo is only paid or reimbursed for the expert fees and other costs to the extent the Insurance Commissioner orders the health plan administrators to pay them.

Alston Hunt does not have to depend on the Insurance Commissioner for its fees. It gets paid no matter what, with our money. I wonder how many legal hours Alston Hunt got to bill UnitedHealth for strategizing how to be the best spokesperson for the bill?

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I'm the mom of a child with disabilities. Hannah's first neurologist said she might never develop beyond the level of a 2 month old infant, and there wasn't anything I could do about it. The brain damage was just too severe. Nine years later, she walks, uses a touchscreen computer and I've just been shown she can learn to construct sentences and do simple math with the right piece of technology. Along the way, I discovered I needed to teach myself what Hannah's rights to services really were. Learning about early intervention services led to reading about IDEA and then to EPSDT. I've been waiting for the Obama administration to realize the power and potential of EPSDT for the medical rights - including the right to stay at home with their families - of children with disabilities. The health reform people talk about long term care, and the disability people talk about education and employment, but nobody is talking about EPSDT. So I am.