Insurance industry accused of making huge profits by delaying claims.

The Huffington Post (12/13, Reilly) reported, "Unlike many other businesses, the insurance industry is bound by law to act in good faith with its customers." Insurance companies were considered "semi-public-trusts." Yet, that changed in the 1990s when their focus shifted from service to profit making. Allstate is credited with originating this trend by adopting a plan crafted by consulting firm McKinsey & Company. The strategy was simple: "Rather than adjusting claims the traditional way, which gave claims managers wide latitude to serve customers, insurers embraced a computer-driven method that produced purposefully low offers to claimants." Customers who accepted "low-ball offers" had their claims processed quickly, while those who refused were forced to wait. "As former Allstate agent Shannon Kmatz told the American Association for Justice, the trial lawyers' lobby, the strategy was to make claims 'so expensive and so time-consuming that lawyers would start refusing to help clients.'"

Med Art and Legal Graphics Co.consults and creates compelling graphic presentations that expose Bad Faith Insurance Practices.

Judge declares mistrial in Roger Clemens perjury case

....this is why you ALWAYS want to be working with a professional trial consultant.

The judge in the Roger Clemens federal perjury trial abruptly declared a mistrial on the second day of testimony after the government inadvertently allowed the jury to hear statements from a U.S. congressman discussing the credibility of one of the key witnesses against the former All-Star baseball pitcher.

U.S. District Judge Reggie Walton was livid Thursday that a video screen was left on in the courtroom while he and the lawyers privately discussed an issue away from the jury, and yet the jurors could clearly see written comments by U.S. Rep. Elijah E. Cummings (D-Md.) during a 2008 House hearing in which Clemens testified he never used steroids or other enhancement drugs.

"Sadly, I have reached this conclusion," Walton said.

At issue was an earlier ruling in which the judge said he would not allow outside testimony or evidence from others about the credibility of certain key witnesses, including Andy Pettitte, a former teammate of Clemens.

Yet appearing on the screen was a transcript of comments by Cummings discussing Pettitte's wife and Pettitte's credibility as one of the lead government witnesses against the seven-time Cy Young award winner.

The government was supposed to have redacted such comments, and was instructed to keep them away from the jury of 10 women and two men so as not to prejudice their deliberations.

"We'll never know what impact that will have on how this jury decides this case, when we have a man's liberty's at stake," said Walton, visibly angry. "I am troubled by this. The government should have been more cautious."

He added, "I don't see how I unring the bell" and keep the jury from considering what Pettitte's wife said and what Cummings thought of it.

"In my view, Mr. Pettitte's testimony is going to be critical as to whether this man goes to prison, and I can't in good faith leave this case where a man's liberty is at risk when the government should have assured we are not in this situation."

Prosecutors said the error was inadvertent. But Rusty Hardin of Houston, Clemens' chief defense attorney, seized on the problem and immediately asked for a mistrial.

"I like this jury," he said. "But…"

On the screen were written comments from Cummings discussing how Laura Pettitte has said her husband "told me he had a conversation with Roger Clemens and Roger admitted to him using human growth hormones." Clemens has insisted he never told Pettitte that he used HGH or steroids, even though his friend and former New York Yankees teammate has said otherwise.

Yet Cummings, from his comments, seemed to believe Pettitte over Clemens.

Cummings' comments were then addressed to Clemens, and his sworn statements that he never told Pettitte he used the drugs.

"If that were true," Cummings' comments continued on the video, "why would Laura Pettitte remember her husband telling her about that?"

Clemens had been charged with perjury, obstruction of justice and making false statements in the latest criminal trial dealing with Major League Baseball players and steroids and other enhancement drugs.

Before ending the trial, the judge left the bench to confer about what to do. But he severely admonished the prosecutors.

"Government counsel doesn't do just what government counsel can get away with doing," he said. "And a first-year law student knows you can't alter the credibility of one witness with clearly inadmissible evidence."

A chagrined judge then dismissed the jury.

"Ladies and gentlemen," he told jurors, "we have taken about a week out of your life. We expended a lot of your taxpayers money to reach this point. Unfortunately there are rules we play by and those rules are designed to insure that both parties receive a fair trial."

The judge continued a gag order precluding Clemens and attorneys and prosecutors discussing the case -- at least until a hearing on Sept. 2 to decide how or whether to jump start the case.

As he left the courtroom, Hardin said, "I would have liked to have gone forward. But we just didn't have a choice."

Richard.serrano@latimes.com

Are Our Personal Medical Records Really Safe with Healthcare Providers?

WASHINGTON | Wed Jun 1, 2011 10:52am EDT

(Reuters) - Patients could obtain a list of everyone who has accessed their electronic medical record under a rule proposed on Tuesday by the U.S. Department of Health and Human Services.

Healthcare providers must currently keep track of everyone who accesses private medical records, but they do not have to provide that information to patients.

"We need to protect people's rights so that they know how their health information has been used or disclosed," said Georgina Verdugo, director of the HHS Office for Civil Rights, which is proposing the changes, in a statement.

Under the rule, patients would be able to request an access report, which would document the identities of those who electronically viewed their protected health information.

The new rule would add to regulations already in place under the Health Insurance Portability and Accountability Act (HIPAA), which protects patient privacy and sets security standards for electronic health records.

"This proposed rule represents an important step in our continued efforts to promote accountability across the health care system, ensuring that providers properly safeguard private health information," Verdugo said.

The move is the latest in a broader effort by the Obama administration to update and streamline the medical records system in the United States.

The changes are authorized under the HITECT act, a measure that was part of the 2009 stimulus package to encourage doctors and hospitals to adopt electronic health records.

Last year, the HHS said any companies, doctors or hospitals that disclose private health information could face fines of up to $50,000 per violation.

The health agency will take comments on the proposed rule until August 1.

HEALTH

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Health insurers reporting double-digit cost increases.

The Chicago Tribune (4/26, Wernau) reports, "Employee-sponsored health plans are seeing a double-digit increase in the cost of claims, an early indication that insurance costs could rise at a similar rate," according a survey conducted by Wells Fargo Insurance Services. The nationwide survey of approximately "60 insurance companies" found that HMOs and point-of-sale plans saw a "9.6-percent increase"; PPOs and consumer driven health plans saw a "10-percent increase"; and prescription-drug plans "increased 8.7 percent." Insurance companies said that the higher costs "were a reflection of healthcare reform provisions, an aging US population, improvements in medical technology and drug therapies," and the use of specialty drugs, among other factors.