Cypress, Calif.-based PacifiCare is pushing back against allegations concerning its claims processing practices made by the California Department of Insurance (CDI).
The Los Angeles Times reported that CDI is accusing PacifiCare of violating state law 992,936 times from 2006 to 2008. The allegations center upon the reimbursement rates for physicians and complaints from consumers that they were denied claims for covered procedures. With the state seeking fines as high as $10,000 for each of the alleged violations, the maximum penalty could be roughly $9.9 billion.
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