Consumer advocate and health insurance reform champion Jay Angoff is back in town.
Angoff, once Health and Human Services Secretary Kathleen Sebelius' right-hand man – and a former director of the Center for Consumer Information and Insurance Oversight (CCIIO) — is going to be representing consumers in litigation against health insurers who are not complying with the Patient Protection and Affordable Care Act (PPACA), at Washington, D.C.-based Mehri & Skalet, PLLC.
"Working at HHS has been immensely rewarding, and I'm pleased with the progress that has been made in implementing the Affordable Care Act," Angoff formally stated of his departure from HHS. "I look forward to returning to Mehri & Skalet to help make sure the law is enforced. The Affordable Care Act has given health insurance policyholders new rights, and will give them even more in 2014; it is critical that we defend those newfound rights."
"We are thrilled to welcome Jay back to the firm as partner," stated partner Cyrus Mehri, in a release Jan. 14. "Jay is a committed consumer advocate with a long history of success. We expect great things of our insurance and healthcare practice under his leadership."
Angoff is going back to his plaintiff's lawyer roots. Years ago, he obtained millions of dollars in refunds for insurance consumers. He was a principal drafter of Proposition 103 in California, the 1988 ballot initiative that rolled back auto insurance rates by 20 percent.
Sebelius appointed him to oversee the implementation of the PPACA insurance reform provisions in February 2010.
He is returning to Washington, D.C., after a stint heading the HHS regional office in Kansas City, Mo.
Before serving at HHS, Angoff was in private practice, first in Jefferson City, MO. and then in Washington with Mehri & Skalet, where he focused on obtaining refunds for individuals who were overcharged by insurance companies, his new (and old) law firm stated. Class actions in which Angoff served as a lead counsel include Landers v. Inter-insurance Exchange of the Automobile Club (Los Angeles County, $24 million settlement), Clutts v. Allstate (Madison County, Ill., $6 million settlement), and Foundation for Taxpayer and Consumer Rights v. GEICO (Los Angeles County, settled at up to $12 million).
"I think with his experience and knowledge related to the development of the regulations and the implementation of the ACA, insurers are going to have to stay on their toes as to how they treat their policyholders and consumers generally, and carry out their responsibilities," said a Washington health insurance lobby representative.
The PPACA already imposes many new requirements and restrictions on health insurers and group health plans. Insurers can no longer impose lifetime benefits limits or, in most cases, rescind coverage. Group plan members with access to dependent benefits can keep children on their plans up to age 26. Another PPACA provision requires insurers to issue refunds if they spend more than 20 percent of individual or small group premiums on administrative expenses.
"While most insurance companies do obey the law, some don't, and the remedies that insurance departments have and also that HHS has are often inadequate," Angoff said today in an interview with National Underwriter Life & Health.
"HHS also doesn't have that much enforcement activity with respect to the individual to order refunds to those who are injured if an insurance company does not obey the standards – that is why private enforcement is necessary," Angoff stated.
HHS has the authority to impose civil penalties if it finds that a state is not enforcing the PPACA, but HHS does not have authority under the law to order refunds for consumers, Angoff said. For consumers, access to a regulator with civil penalty authority is not enough, he said.
The PPACA law is written in such a way that it doesn't provide an adequate remedy for noncompliance — it does not have authority under the law to order refunds for consumers, Angoff said.
That's where his new law firm will come in. 
