TRENTON, N.J.-Enrollment in New Jersey's Individual Health Coverage Program has reached 71,982. Established under the state's 1992 healthcare reform law, the program provides health insurance coverage to people who may not otherwise have access to an insurance plan. Typically, they include the self-employed, those who don't have access to a group health plan through their employer and the unemployed who have exhausted continuation of benefits plans. A total of 22 carriers offer a choice of five standardized indemnity or HMO plans. Those eligible for the insurance cannot be denied coverage and face few restrictions on the coverage of pre-existing conditions. The plans are community-rated so that everyone pays the same rate regardless of age, sex, profession, health status or place of residence.
HARRISBURG, Pa.-Twelve managed-care providers are bidding on the state's managed-care contract for Medicaid patients in southeastern Pennsylvania. Providers selected to participate in "HealthChoices" will provide managed-care coverage to 650,000 beneficiaries of the state's Medicaid program, known as Medical Assistance. Despite several lawsuits over the program's regulations and implementation, the state intends to select bidders and have the program in place by the fall.
HARTFORD, Conn.-Several patients and their physicians have filed lawsuits against Cigna HealthCare of Connecticut, claiming the HMO has interfered with the physician-patient relationship. The lawsuits stem from action taken by Cigna in May when it announced it was dropping Hartford Hospital from the plan and changing the way it contracts with physicians in
Hartford and Tolland counties. Many patients said the changes would mean they no longer would be able to see specialists who had been dropped by the HMO. Two lawsuits, one by patients and the other by medical specialists, were filed Sept. 2 in Hartford Superior Court. Seven New Britain physicians and nine of their patients from four central
Connecticut towns are suing for unspecified damages and to stop Cigna from dropping the physicians from the HMO. The patients claim they will either have to pay their own high medical bills or switch to different specialists and endure hardship and emotional distress. The suit is based on the state's laws on unfair trade and insurance practices. Cigna is alleged to have misrepresented and falsely advertised insurance policies. The physicians contend Cigna HealthCare unilaterally ended their contracts and denied them a chance to re-enroll. Cigna spokesman Mark A. DiGiorgio said company executives hadn't seen the lawsuits and would not comment on them.-Associated Press