NBC Nightly News (1/13, story 6, :35, Williams) reported, "One of the nation's biggest health insurers has agreed to pay $50 million to settle accusations that it overcharged millions of customers." The settlement "could save patients money down the road," the CBS Evening News (1/13, story 8, 2:10, Couric) added.
USA Today (1/14, Appleby) notes, "UnitedHealth Group has agreed to end a practice that allegedly caused patients to overpay for care outside the insurer's network." In doing so, UnitedHealth "will close a much-criticized database health insurers have used for years to determine payment rates and help start a more impartial successor," the AP (1/14, Murphy) adds. The agreement resolves an investigation by New York Attorney General Andrew Cuomo into allegations that the database, run by UnitedHealth subsidiary Ingenix, "intentionally skewed rates lower through faulty data collection."
Cuomo claimed that the relationship between Ingenix and UnitedHealth "is a gross conflict of interest" that "gave Ingenix an incentive to set rates that benefited" the insurer, according to Bloomberg News (1/14, Freifeld). Under the settlement, "a nonprofit entity will provide data on 'reasonable and customary' costs that insurers use to set reimbursement rates to patients," he explained. Cuomo "plans to get the new entity up and running in six months," including "a website where, for the first time, consumers can find out in advance how much they may be reimbursed for common out-of-network services in their area."
The Chicago Tribune (1/14, Japsen) reports that the agreement is expected to have a "much broader" impact than on the 26 million UnitedHealth members alone, "because other health plans...use the Ingenix database," Cuomo and the American Medical Association stated. The attorney general "is now investigating other insurance companies that use Ingenix's database," including Aetna, CIGNA, and WellPoint/Empire BlueCross BlueShield, "to determine reimbursement rates for patients," MSNBC (1/13, Dahl, et al.) noted. The New York Daily News (1/14, Gaskell) and the Milwaukee Business Journal (1/14, Vomhof) also covered the story.
Copyright © 2008 by Custom Briefings | 11190 Sunrise Valley Drive, Suite 130 | Reston, VA 20191