Cigna Whistleblower to Testify

Former Health Insurance Executive Expected to Testify on Capitol Hill

(CBS)  CBS News has learned a former executive for a major health insurance company, Cigna, will speak out for the first time before Congress tomorrow on practices that he is expected to characterize as deceptive by the health insurance industry.

Wendell Potter, the former Vice President of Communications for Cigna Insurance Company in Philadelphia is scheduled to testify at 2:30 pm before the Senate Commerce Committee. He is expected to describe how the health insurance industry purposefully uses "confusing language" for consumers as part of its business strategy. He worked in the health insurance industry for 20 years for both Cigna and Humana health insurance companies.

Cigna spokesperson Chris Curran told CBS that Potter retired from Cigna over a year ago. Curran says the company launched an effort to simplify its language with consumers a year and a half ago, "We do feel it is important that individuals understand what they have and what they are entitled to," he said.

Curran says the company's efforts are part of a program they call "Words We Use" which for example includes using "process" instead of "adjudicate". Another example, instead of using "after a comprehensive appraisal of the circumstances" they now tell consumers, "after reviewing your case."

The chairman of the Senate Commerce Committee, Jay Rockefeller D, WV released a statement to CBS News criticizing any business practices that confuse patients, "Consumers can’t challenge insurance companies’ decisions because the companies don’t explain the terms of coverage in clear, understandable language.”

The Committee will also release the results of its investigation into the practices of 18 different health insurance companies. The investigation is expected to show that health care companies routinely set out of pocket reimbursement rates know as "usual and customary" rates based on questionable information.