Insurer interference has doctors, patients concerned

Health care reform may bring relief, but one lobbyist sounds a pessimistic note.

KETTERING — In six years, Bill Powers, who has a family history of severe heart disease, tried five different medications to try to bring his high cholesterol under control. But it wasn’t until his physician prescribed Crestor in 2006 that Powers saw his count plummet below the danger level to 154.

Regardless, Powers’ insurance company, Anthem, declined to pay for the medication because he hadn’t tried older, less costly alternative drugs within the last 180 days. Powers appealed and, a month later, Anthem approved coverage.

“Ninety-nine out of a hundred people” wouldn’t have fought the insurer, Powers said. “I just happen to be someone who is easily annoyed.”

Consumers aren’t the only ones annoyed by insurance company policies. Doctors say they are increasingly frustrated with insurers’ denying and delaying coverage of prescribed therapies, and sometimes even switching them. “You’re totally working within the constraints of the (insurance) plans,” said Dr. Lawrence Mieczkowki, a Kettering internist.

Dr. Darrell Lynn Grace of Dayton said her practice employs a full-time clerk “just to deal with pre-authorization” of therapies.

Insurance companies say they have medical directors and panels of physicians who set their therapy guidelines. In the case of Crestor, studies didn’t show until late 2008 that it was effective against heart attacks, said Anthem spokeswoman Kim Ashley.

Health care reform bills now in Congress would streamline procedures for pre-authorization of treatment, said Tim Maglione, a lobbyist for the Ohio State Medical Association. But he said insurers will have an incentive to interfere in patient care as long as profit remains an industry motive.

“Every time they pay a claim for covered services, they consider that a loss on their financial books,” he said.

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