P age A 8
M a r ch 17, 1999
(T^e llortkuib ©bseruer
Nutrition Review Helps Kids’
Diets ‘Make the Grade’
H O USTON (M arch 5, 1999)
Does your ch ild ’s nutrition report
card read 'needs im provem ent’? If
so, y o u ’re not alone.
"A lth o u g h A m erican ch ild ren
a re n ’t exactly failing nutrition, there
a re n ’t m any making the healthy-diet
honor roll," said Dr. D ebby-l uce ot
the U S D A ’s C hildren’s N utrition
Research Center at Baylor College o f
M edicine in Houston.
The food groups in greatest need
o f attention are fruits and v egetables.
dairy products and w hole grains.
“ Busy lifestyles can make ensuring
the quality o f children's diets very
c h a lle n g in g .
P a re n ts, d a y c a re
p r o v id e r s , sc h o o l c a f e te r ia s ,
restaurants and fast food, playm ates'
fam ilies, and children them selves
influence the nutritional soundness
o f their diet," said D em ory-Luce, a
o f m eat per day.
registered dietitian. Eating on the
M ake breakfast a priority. Studies
run, skipping meals and ju n k food
show
that breakfast eaters have a
snacking can also be a problem.
better overall diet and have less
To help y o u r c h ild re n ’s d iets
t r o u b l e
im p ro v e ;
c o n c e n tra tin g and
D em o ry -L u ce
fe w e r
b e h a v io r
Studies show that
o f fe rs
th e se
problem s in school.
nutrition ’study’
breakfast eaters have
An ideal breakfast
tips:
in c lu d e s
so m e
a
better
overall
diet
Tutor children
protein,
a
little
fat,
o n u s in g th e
and have less trouble
p
le
n
ty
of
food groups as a
carbohydrates
and
a
concentrating
and
daily guide and
g
o
o
d
s
o
u
r
c
e
o
f
rein fo rce good
fewer behavior
ca
lc
iu
m
.
E
v
en
a
eating habits by
problems in school.
peanut
b u tte r
being a good role
sandw ich and a box
m o d e l.
M o st
o f calcium fortified
c h ild r e n n ee d
orange juice in the m orning is good.
about six servings o f grain-based
Think sm art snacks, k e e p ready-to-
foods, five servings o f fruits and
eat vegetables an d low -fat dips,
vegetables, the equivalent o f three
raisins or other dried or fresh fruit.
to four glasses o f milk, and slx ounces
ready-to-eat fortified cereal, fig-type
or oatm eal cookies, w hole grain
mozzarella ‘stringcheeseandcalcium -
fortified ju ic es in easy reach. Also,
work w ith your childcare provider or
after-school program to m ake sure
nutritious snacks are available.
Increase the nutritional ‘p in ch ’ o f
m eals eaten at home. U se dark green
and deep yellow orange fruit b reads;
add finely m inced, cooked vegetables
such as zucchini, spinach, carrot, and
broccoli to soups, casseroles and
pasta sauces; and replace the w ater
in som e recip es w ith v eg etab les
juices. A lso, add a few tablespoons
o f dry m ilk pow der to soups, m ashed
potatoes, gravies and oatm eal; top
breakfast cereal w ith fresh or dried
fruit; and be sure to buy 100 percent
w hole grain breads.
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i S im p lic it y P a tte r n s
PacifiCare fined $50,000 for
claims-handing practices
SALEM Oregon D epartm ent o f
C onsum er and Business Services
(DCBS) has assessed a $50,000 fine
against PacifiCareofO regon. Inc., for
failu re to co m p ly w ith O regon
standards for the handling o f health
insurance claims.
The action resulted from a market
conduct exam iners o f the com pany' s
operation by the Insurance D ivision
ofDCBS. Examiners reviewedclaims-
handling practices o f PacifiCare and
h e a lth c a re p r o v id e r s g ro u p s
a u th o riz e d to h an d le c la im s on
P acifiC are’s b eh alf for the period o f
July 1994toJune 1997.
“We
fo u n d
s u b s ta n tia l
n o n c o m p lia n c e w ith im p o rta n t
claim s-h an d lin g sta n d ard s," said
D eputy Insurance C om m issioner
N ancy E llison
“ Som e have the
violations involved claim s handled
directly by PacifiCare, but the highest
levels o f noncom pliance involved
claim s handled by provider groups
that had been d eleg ated claim s-
h a n d lin g r e s p o n s i b ilit ie s by
PacifiCare.
"O regon law allow s insurers to
delegate claim s handling, but only
under strict insurer supervision,"
continued Ellison. "O ur action in this
case reflects the Insurance D ivision’s
com m itm ent to requiring insurers to
m o n ito r c lo se ly p ro v id e r group
com pliance w ith O regon law ."
E llison also noted the initial follow-
up m a d e e x a m in e r s in d ic a te d
s ig n i f ic a n t
im p r o v e m e n t in
P acifiC are’s m onitoring activity and
claim s-handling practices. A m ong
the specific problem s identified in
the m ark et co n d u c t rep o rt w ere
find in g s that P acifiC are an d its
authorized provider groups violated
O re g o n in s u r a n c e la w a n d
adm in istrativ e rules by.
Failing w ithin 20 w orking days to
acknow ledge or pay claim s.
Failing w ithin 20 w orking days to
n o tify first p a rty claim an ts that
P acifiC are need ed m ore tim e to
determ ine w hether to accept o r deny
claim s and the reason for the delays,
and failing to notify claim ants every'
45 d a y s th e r e a f te r w h ile th e
investigation rem ained incomplete.
Exam iners also determ ined that
PacifiCare, by its authorized provider
groups, violated O regon insurance
law and adm inistrative rules by fai ling
to provide a w ritten explanation ot
the reason o f denial in 67 percent of
the denied claim files exam ined, and
b y d e n y in g c la im s w ith o u t
c o n d u c tin g
a
re a s o n a b le
investigation.
Problem s w ith claim s handling
standards w ere cited in two earlier
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The
URBAN
|
o f P o r t la n d
y
j
m arket co n d u c t ex am in atio n s o f
PacifiC are covering the periods o f
1989 to 1991 and 1991 to 1994. In 1996.
DCBS fined PacifiCare $20.000 for
denying em erg en cy room claim s
w ith o u t co n d u ctin g a reasonable
investigation.
The insurance D ivision plans to re­
exam ine P acifiC are in late 1999 to
ensure that violations have been
corrected.
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