For $50 million, UnitedHealth Group Inc. agreed to settle a probe brought by New York”™s attorney general, who has investigated how much insurance carriers charge for care outside of their existing network of doctors.
New York AG Andrew Cuomo investigated a UnitedHealth subsidiary called Ingenix, which is the largest provider of health-care billing information in the nation.
Cuomo focused on whether the Ingenix database intentionally skewed downward the “usual and customary” rates for medical care through faulty data collection, poor pooling procedures, and a lack of audits. The prosecutor said that using the database, insurers underpaid policyholders between 10 percent and 28 percent less than what they might have otherwise received for medical services.
In February 2008, Cuomo subpoenaed several other carriers using the Ingenix database, including Hartford, Conn.-based Aetna Inc.; Indianapolis-based WellPoint Inc.; and Philadelphia-based CIGNA Corp.
The UnitedHealth payment will be used to set up a new, independent data
base administered by a nonprofit organization to track out-of-network reimbursement rates.
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