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WellPoint Health Networks Inc.

Self Description

August 2003: "WellPoint is one of the nation's largest publicly traded health care companies serving the needs of more than 13 million medical members and over 49 million specialty members....WellPoint was formed in 1992 to operate Blue Cross of California's managed care business. In 1996, WellPoint and Blue Cross of California merged into a single stockholder-owned company, WellPoint Health Networks Inc. (NYSE:WLP)."

Third-Party Descriptions

March 2014: 'WellPoint, which recently acquired AmeriGroup for $4.9 billion, referred questions to TennCare, where officials said privacy laws did not allow discussion of the case. But Kelly Gunderson, a TennCare spokeswoman, added that in any long­term care program, “difficult public policy decisions must be made, including whether to provide an unlimited array of benefits to a few, or a reasonable package of benefits sufficient to safely serve individuals in the community to many.”'

March 2012: "Others idolize their doctors, which creates its own challenges. Dr. Sam Nussbaum, chief medical officer at the insurance giant WellPoint, which makes patient reviews of its network doctors available for all customers to see, explains it another way. The insurer has found that only roughly 20 percent of customers will switch to a generic drug or use a less expensive imaging center, even if there is no health risk. Why? Because their doctor told them so."

June 2010: "The Wall Street executives who needed the government to prop them up, but still thought their services were worth millions a year, were cast by Mr. Obama as a shameless privileged class. Toyota was described as seeking profits over safety; Wellpoint, the insurance giant, was castigated for seeking to insulate itself from the new health care legislation by taking actions that the law will soon prohibit."

April 2009: 'Adding more COBRA cases could bump up claim totals. But it also could encourage healthier people to enroll and balance out the risk. "We're assuming the bottom-line impact will not be significant one way or the other," said Ken Goulet, president and chief executive of Indianapolis-based WellPoint's commercial business unit. WellPoint is the largest health insurer, based on membership.'

December 2007: "Over the next year, the rankings will become more transparent and thorough under agreements reached in recent months between several of the biggest health insurers and New York Attorney General Andrew Cuomo. Aetna, Cigna, UnitedHealthcare and WellPoint have said they'll apply the agreed-upon approach to their ratings nationwide."

October 2007: WellPoint, one of the nation’s largest insurers, had “a backlog of approximately 354,000 claims” at certain Medicare plans offered through its UniCare subsidiary. The company’s call center took an average of 27 minutes to answer phone calls from its members and 16 minutes to answer calls from health care providers. More than half the callers hung up before speaking to a company representative. Karen Brown, a spokeswoman for WellPoint, had no immediate comment.

January 2002: A federal appeals court upheld the law in October 2000, ruling on behalf of a woman who sought reimbursement for specialized shoulder surgery that she obtained at her own expense after her doctor recommended it but her health maintenance organization refused to authorize it. The H.M.O., Rush Prudential HMO, an Illinois affiliate of Wellpoint Health Networks, said it would cover a simpler and less expensive treatment for the severe shoulder pain the woman, Debra C. Moran, was experiencing. Arguing that the state law was invalid, it refused to submit the dispute for an independent review.


RoleNameTypeLast Updated
Owner of (partial or full, past or present) AmeriGroup Corporation Organization Mar 8, 2014
Owner of (partial or full, past or present) Anthem Blue Cross and Blue Shield Organization Sep 7, 2006
Owner of (partial or full, past or present) Empire HealthChoice Assurance Organization Feb 15, 2008

Articles and Resources

Date Resource Read it at:
Mar 06, 2014 Pitfalls Seen in a Turn to Privately Run Long-Term Care

QUOTE: a closer look at Tennessee, widely cited as a model, reveals hidden pitfalls as the system of caring for the frail comes under the twin pressures of cost containment and profit motive. In many cases, care was denied after needs grew costlier — including care that people would have received under the old system. “The notion of prevention saving money in the long run only works if you actually provide care in the long run,” 

New York Times
Mar 09, 2012 The Web Is Awash in Reviews, but Not for Doctors. Here’s Why.

QUOTE: RateMDs now has reviews of more than 1,370,000 doctors in the United States and Canada. But getting in the faces of the previously untouchable professional class has inevitably led to legal threats. He says he gets about one each week over negative reviews and receives subpoenas every month or two for information that can help identify reviewers, who believe they are posting anonymously.

New York Times
Jun 17, 2010 Obama’s Twist of BP’s Arm Stirs Debate on Frequent Tactic

QUOTE: President Obama’s successful move to force BP to establish a $20 billion compensation fund that the company will have no voice in allocating — just a down payment, the president insisted — may have been the most vivid example of what he recently called his determination to step in and do “what individuals couldn’t do and corporations wouldn’t do.” With that display of raw arm-twisting, Mr. Obama reinvigorated a debate about the renewed reach of government power, or, alternatively, the power of government overreach.

New York Times
Sep 08, 2009 When Your Insurer Says You're No Longer Covered: Firms Defend 'Rescissions' as Fraud Control

QUOTE: Rescission -- the technical term for canceling coverage on grounds that the company was misled -- is often considered among the most offensive practices in an insurance industry...

Washington Post
Jul 06, 2009 Familiar Players in Health Bill Lobbying: Firms Are Enlisting Ex-Lawmakers, Aides

QUOTE: The nation's largest insurers, hospitals and medical groups have hired more than 350 former government staff members and retired members of Congress in hopes of influencing their old bosses and colleagues.... public interest groups and reform advocates complain that the concentration of former government aides on K Street has distorted the health-care debate,

Washington Post
Jun 25, 2009 Big Health Firms Underpay Claims

QUOTE: Congressional investigators have discovered that large health insurers in every region of the country are relying on faulty databases to underpay millions of valid insurance claims.

Wall Street Journal, The (WSJ)
Apr 08, 2009 The New Federal COBRA Subsidy Worries Employers

QUOTE: A new government subsidy that helps the unemployed keep their health insurance has left recession-weary employers nervous about the financial hit they may take if more people stay covered under their plans. Although the subsidy covers most of the premium, many employers remain worried that they'll be left holding the bag on costs, according to a new survey. Especially concerned are self-insured employers, which pay medical claims themselves.

Dec 16, 2007 Doctor Ratings Revised (Health Costs)

QUOTE: Several health-insurance companies have recently agreed to improve their existing or planned ratings of physicians....Ratings by some insurers have come under fire for giving top scores to doctors who cost the least -- but who are not necessarily the best in quality or the ones handling the most complex cases. In some plans, there are financial incentives for members to pick high-scoring doctors for their care.

Wall Street Journal, The (WSJ)
Oct 07, 2007 Medicare Audits Show Problems in Private Plans

QUOTE: Tens of thousands of Medicare recipients have been victims of deceptive sales tactics and had claims improperly denied by private insurers that run the system’s huge new drug benefit program and offer other private insurance options encouraged by the Bush administration...

New York Times
Mar 24, 2007 Pediatricians Voice Anger Over Costs of Vaccines

QUOTE: The soaring cost and rising number of new vaccines, doctors say, make it increasingly difficult for them to buy the shots they give their patients. They also complain that insurers often do not reimburse them enough, so they can lose money on every dose they deliver...As a result, some pediatricians are not offering the newest and most costly vaccines.

New York Times
Jul 17, 2006 Bush Administration Plans Medicare Changes

QUOTE: The Bush administration says it plans sweeping changes in Medicare payments to hospitals that could cut payments by 20 percent to 30 improve the accuracy of payment rates...the effects could be devastating.

New York Times
Jun 08, 2006 Unlocking The Mystery Of Health Care Pricing

QUOTE: Both physicians and insurers profit from the current system in which pricing is so complicated that it is sometimes impossible to determine what a given procedure or office visit will cost.

May 25, 2006 The Check Is Not in the Mail

QUOTE: Tardiness or refusal to pay what doctors consider legitimate medical claims may add as much as 15 to 20 percent in overhead costs for physicians, forcing them to pursue those claims or pass along the costs to other patients...

New York Times
May 25, 2006 Health Insurers Put to Test

QUOTE: Doctors and nurses gripe that insurers take too long to pay claims, or they deny claims for mysterious reasons that would require a PhD in logic to decode. One entrepreneur with a famous pedigree wants to hold health payers accountable for those faults...

Aug 14, 2003 CareFirst Is Target of Federal Investigation

QUOTE: ...turning the not-for-profit insurer [CareFirst]into a for-profit company that sought to reward executives with multimillion-dollar salaries and bonuses...

Washington Post
Jan 17, 2002 Justices Hold Hearing in Case Concerning Patients' Rights

QUOTE: ...the spotlight moved to the Supreme Court today for an argument on whether states have the authority to require an independent medical review of a health maintenance organization's refusal to pay for a covered service.

New York Times