Stopping Insurer Bad Behavior

Insurers must be held accountable for constantly trying to skirt their legal obligation to provide fair and timely reimbursement. ACEP strongly supports the enforcement of laws and regulations meant to halt these patterns of bad behavior.

ACEP is fiercely committed to working with Congress, state and federal regulators to make sure insurance companies conduct business in good faith and consistent with current law.

Recent Advocacy Efforts

ACEP is applying the pressure necessary to compel insurance companies to roll back dangerous and frequently unlawful policies including payments denied or downcoded, insurer threats to cut rates or face network removal, and other maneuvers that run directly counter to the Prudent Layperson Standard and established state or federal laws.  

When UnitedHealthcare announced a policy that put patients at risk, ACEP sprung into action by generating significant media coverage, mobilizing a coalition of concerned stakeholders, and prompting Congressional scrutiny. As a result, UnitedHealth backed down in only six days.

ACEP took the fight against Anthem to court in Georgia with a compelling case that led to the insurer discontinuing its dangerous policy to retroactively deny claims.  

ACEP and the California chapter joined forces to alert legislators about Anthem’s egregious tactics across the state, denying physician reimbursement for level five emergency care. 

In North Carolina, Blue Cross Blue Shield and UnitedHealthcare were caught exploiting the No Surprises Act to justify threatening emergency physicians with rate cuts between 20 to 40%. ACEP and the North Carolina College of Emergency Physicians sounded the alarm and alerted state officials about insurers’ strongarm tactics.