Word: kaiser
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...Viagra, it's easy to forget that many women aren't even covered for the Pill. Now Senator Olympia Snowe of Maine is pushing a bill that would require large plans that cover drugs to pay for all prescription forms of birth control. About half of all plans, including Kaiser Permanente and Prudential, now cover some form of protection, from the Pill to diaphragms and IUDs...
...seemed an obvious ploy: Perenchio, as head of Univision, the major Spanish-language TV network, was seeking to curry favor with his audience. But Perenchio wasn't alone. Millions of dollars are now being poured into pro-Latino causes by such corporations as AT&T, GTE, Miller Brewing and Kaiser Permanente. One grass-roots group, the Southwest Voter Registration Project, has received a $500,000 pledge from State Farm Insurance (to be paid over five years), and its recent "Feel the Power" convention was partly sponsored by ARCO (a company that was boycotted by Hispanics in 1994 after it supported...
...health plans squeezed, their profits grew--at least until recently. Pressured by rising medical costs on one side and employers' refusal to pay higher premiums on the other, a number of managed-care firms began running into trouble. Case in point: Kaiser Permanente, which posted a $270 million loss last year. This was on the heels of a sudden $291 million loss at Oxford Health Plans of Norwalk, Conn., which CEO Stephen Wiggins blamed on the collapse of his overtaxed computer billing system. Wiggins was forced to resign, but that wasn't the end of his troubles. Last week...
Even with improved quality control, there will still be times when financial considerations prevail. Kaiser's decision on Viagra is a case in point. From the moment the impotence pill was approved, Kaiser's top executives knew they had a high-visibility issue on their hands. They turned it over to a committee of 40 doctors, nurses, pharmacists and other experts, who took the position that Viagra is not, strictly speaking, a medical necessity. Then the committee calculated the cost of providing Viagra to Kaiser's members at $100 million a year, significantly dwarfing, for example...
...Whether Kaiser's policy will stand is another question. Last week officials from California's department of corporations, which licenses the state's HMOs, announced that they are investigating Kaiser's decision on Viagra. At issue: a state law that requires health plans to cover all treatments that are medically necessary. Believe it or not, there are situations in which Viagra could qualify as a medical necessity. For example, many men refuse medical treatments, such as prostate surgery, for fear they might be rendered impotent. Viagra could allow them to proceed with a life-saving operation without diminishing their quality...