Health Net
Encyclopedia
Health Net, Inc. is among the United States of America's largest publicly traded health insurers. The company’s HMO
, POS
, insured PPO
and government contracts subsidiaries provide health benefits to approximately 6.6 million individuals in all 50 states and the District of Columbia through group, individual, Medicare
, Medicaid
and TRICARE
and Veterans Affairs
programs. Health Net’s behavioral health services subsidiary, MHN, provides behavioral health, substance abuse and employee assistance programs (EAPs) to approximately 7.3 million individuals in various states, including the company’s own health plan members. The company’s subsidiaries also offer managed health care products related to prescription drugs, and offer managed health care product coordination for multi-region employers and administrative services for medical groups and self-funded benefits programs.
Health Net's headquarters are located in Woodland Hills, Los Angeles
, California
.
North region provider as of July 1, 2004. Health Net's bid for the Tricare North region business contract, effective starting April 1, 2010, was awarded to Aetna
, however Aetna's contract has been suspended pending the outcome of Health Net's protest. On November 4, 2009 the GAO upheld Health Net's protest. On May 13, 2010 Health Net Federal Services was formally awarded the contract as the TRICARE Managed Care Support (MCS) contractor for the TRICARE North Region by the Department of Defense (DoD). The announcement followed the May 5, 2010 news of the DoD's intent to award.
' largest fund-raising event, March for Babies
. In 2008, more than 300 Health Net associates walked in March for Babies events across California contributing more than $325,000 through various fund-raising efforts.
for diet purposes and stated an inaccurate weight; Bates replied that the insurance broker had filled out the form for her and she had been busy in her salon. In February 2008 the court ruled in favor of Bates, ordering Health Net to pay $8.4 million in punitive damages and $750,000 for emotional distress.
attorney general Richard Blumenthal said Health Net lost the personal information of nearly 450,000 state residents and "failed to inform consumers for six months." The data on the drive was unencrypted and included information about financial, health, and personal information. It was discovered missing from the company's Connecticut office. Health Net circulated a letter to customers in December 2009, including an offer of free credit protection from a company called Debix
for two years.
The suspension required Health Net to cease marketing and enrollment of new members of all Health Net Medicare Advantage Prescription Drug (MAPD) and stand-alone Prescription Drug Plan (Part D) contracts, effective November 20, 2010. The sanctions relate to compliance with certain Part D requirements. The suspension did not affect existing Health Net Medicare enrollees.
Health Net's missing computer records represent the largest data breech reported to the Office for Civil Rights (OCR) website and the third largest medical information breach in the Privacy Rights Clearinghouse database. The data breech effects roughly 1.9 million people including 845,000 Californians, 100,000 Oregonians, 3,500 Vermonters and thousands more in other states.
The company offered two years free credit monitoring along with identity theft insurance to those affected. The Californian Department of Managed Health Care and the Department of Insurance have announced separate investigations into the breach.
Rancho Cordova's Health Net division may see layoffs
Health insurer tied bonuses to dropping sick policyholders
February 23, 2008: Health Insurer Fined $9M for Dropping Calif. Breast Cancer Patient in Middle of Her Chemo
Health maintenance organization
A health maintenance organization is an organization that provides managed care for health insurance contracts in the United States as a liaison with health care providers...
, POS
Point of service plan
A point of service plan, or POS plan, is a type of managed care health insurance system. It combines characteristics of both the HMO and the PPO. Members of a POS plan do not make a choice about which system to use until the point at which the service is being used.The POS is based on the basic...
, insured PPO
Preferred provider organization
In health insurance in the United States, a preferred provider organization is a managed care organization of medical doctors, hospitals, and other health care providers who have covenanted with an insurer or a third-party administrator to provide health care at reduced...
and government contracts subsidiaries provide health benefits to approximately 6.6 million individuals in all 50 states and the District of Columbia through group, individual, Medicare
Medicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
, Medicaid
Medicaid
Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent...
and TRICARE
TRICARE
TRICARE, formerly known as the Civilian Health and Medical Program of the Uniformed Services , is a health care program of the United States Department of Defense Military Health System. TRICARE provides civilian health benefits for military personnel, military retirees, and their dependents,...
and Veterans Affairs
Veterans Affairs
Veterans Affairs is a term of the business that deals with the relation between a government and its veteran communities, usually administered by the designated government agency. It might refer to:*Department of Veterans' Affairs...
programs. Health Net’s behavioral health services subsidiary, MHN, provides behavioral health, substance abuse and employee assistance programs (EAPs) to approximately 7.3 million individuals in various states, including the company’s own health plan members. The company’s subsidiaries also offer managed health care products related to prescription drugs, and offer managed health care product coordination for multi-region employers and administrative services for medical groups and self-funded benefits programs.
Health Net's headquarters are located in Woodland Hills, Los Angeles
Los Ángeles
Los Ángeles is the capital of the province of Biobío, in the commune of the same name, in Region VIII , in the center-south of Chile. It is located between the Laja and Biobío rivers. The population is 123,445 inhabitants...
, California
California
California is a state located on the West Coast of the United States. It is by far the most populous U.S. state, and the third-largest by land area...
.
Divisions
Health Net Federal Services, Inc. (HNFS) is the government operations division of Health Net. It is the TRICARETRICARE
TRICARE, formerly known as the Civilian Health and Medical Program of the Uniformed Services , is a health care program of the United States Department of Defense Military Health System. TRICARE provides civilian health benefits for military personnel, military retirees, and their dependents,...
North region provider as of July 1, 2004. Health Net's bid for the Tricare North region business contract, effective starting April 1, 2010, was awarded to Aetna
Aetna
Aetna, Inc. is an American health insurance company, providing a range of traditional and consumer directed health care insurance products and related services, including medical, pharmaceutical, dental, behavioral health, group life, long-term care, and disability plans, and medical management...
, however Aetna's contract has been suspended pending the outcome of Health Net's protest. On November 4, 2009 the GAO upheld Health Net's protest. On May 13, 2010 Health Net Federal Services was formally awarded the contract as the TRICARE Managed Care Support (MCS) contractor for the TRICARE North Region by the Department of Defense (DoD). The announcement followed the May 5, 2010 news of the DoD's intent to award.
Health Net sponsorships
Since the 1980s, Health Net has been a sponsor of the March of DimesMarch of Dimes
The March of Dimes Foundation is a United States nonprofit organization that works to improve the health of mothers and babies.-Organization:...
' largest fund-raising event, March for Babies
March for Babies
The March of Dimes's March for Babies, formerly WalkAmerica, began in 1970 as the first charitable walking event in the United States. The name was changed after the 2007 event....
. In 2008, more than 300 Health Net associates walked in March for Babies events across California contributing more than $325,000 through various fund-raising efforts.
Quality of care
In California's Health Care Quality Report Card 2011 Edition by California's Office of the Patient Advocate, HealthNet (CA) received 2 out of 4 stars in Meeting National Standards of Care.Patsy Bates lawsuit
In 2007, Patsy Bates, a California beautician, sued Health Net claiming that they wrongfully terminated her care in the middle of her chemotherapy treatments. Internal company documents made public during the law suit revealed that the company had tied bonuses to dropping coverage in order to encourage its analysts in charge of recission reviews to discover reasons (such as application fraud) to discontinue coverage to clients who the company deems will cost them money. The company pointed out that Bates had withheld critical information - that she had damaged her heart by the use of fen-phenFen-phen
The drug combination fenfluramine/phentermine, usually called fen-phen, is an anti-obesity treatment that utilizes two anorectics. Fenfluramine, its S-enantiomer dexfenfluramine, and a few other serotonin agonists were shown to cause potentially fatal pulmonary hypertension and heart valve...
for diet purposes and stated an inaccurate weight; Bates replied that the insurance broker had filled out the form for her and she had been busy in her salon. In February 2008 the court ruled in favor of Bates, ordering Health Net to pay $8.4 million in punitive damages and $750,000 for emotional distress.
Connecticut attorney general investigation
In November 2009, ConnecticutConnecticut
Connecticut is a state in the New England region of the northeastern United States. It is bordered by Rhode Island to the east, Massachusetts to the north, and the state of New York to the west and the south .Connecticut is named for the Connecticut River, the major U.S. river that approximately...
attorney general Richard Blumenthal said Health Net lost the personal information of nearly 450,000 state residents and "failed to inform consumers for six months." The data on the drive was unencrypted and included information about financial, health, and personal information. It was discovered missing from the company's Connecticut office. Health Net circulated a letter to customers in December 2009, including an offer of free credit protection from a company called Debix
Debix
Debix is a credit monitoring service based out of Austin, Texas. The company was founded in 2004 and reports to have protected over 800,000 consumers since. Debix provides data breach solutions for organizations as well as consumer protection through its OnCall Credit Monitoring. Major clients...
for two years.
CMS suspension
On November 19, 2010, the Centers for Medicare and Medicaid Services (CMS) immediately suspended Health Net because the insurer improperly administered the Medicare drug benefit in contracts for its national prescription drug plan and local Medicare Advantage prescription drug plans.The suspension required Health Net to cease marketing and enrollment of new members of all Health Net Medicare Advantage Prescription Drug (MAPD) and stand-alone Prescription Drug Plan (Part D) contracts, effective November 20, 2010. The sanctions relate to compliance with certain Part D requirements. The suspension did not affect existing Health Net Medicare enrollees.
Network data breach
On March 14, 2011 Health Net disclosed that nine server drives, containing personal information of 1.9 million members and providers, went missing from its Rancho Cordova (CA) data center. The insurer found out about the security lapse on January 21 when IBM, which manages the company's IT infrastructure, informed Health Net it was unable to locate the missing server drives.Health Net's missing computer records represent the largest data breech reported to the Office for Civil Rights (OCR) website and the third largest medical information breach in the Privacy Rights Clearinghouse database. The data breech effects roughly 1.9 million people including 845,000 Californians, 100,000 Oregonians, 3,500 Vermonters and thousands more in other states.
The company offered two years free credit monitoring along with identity theft insurance to those affected. The Californian Department of Managed Health Care and the Department of Insurance have announced separate investigations into the breach.
External links
Rancho Cordova's Health Net division may see layoffs
- http://www.sacbee.com/103/story/766746.html
Health insurer tied bonuses to dropping sick policyholders
- http://www.latimes.com/business/la-fi-insure9nov09,1,5878955,print.story?ctrack=5&cset=true
February 23, 2008: Health Insurer Fined $9M for Dropping Calif. Breast Cancer Patient in Middle of Her Chemo
- http://www.rawstory.com/news/mochila/Insurer_that_cut_client_s_care_fine_02232008.html