Insurer Settles in Database Investigation
UnitedHealth Group has agreed to a settlement in the investigation of its insurance database by New York State Attorney General Andrew Cuomo. According to reports, the company allegedly ran a database through its Ingenix business unit that repeatedly underpaid patients who sought care from out-of-network doctors.
Using the database to determine reimbursement, health insurers paid patients for 70 to 80 percent of the "reasonable and customary" cost of out-of-network medical care. However, according to reports, the database often underestimated fees, leaving patients to foot more of the bill. Cuomo stated that the database was allegedly receiving fee data from insurers and then supplying reimbursement information to insurers, creating a "closed loop," reports noted.
As part of the settlement, UnitedHealth will provide $50 million to fund a new database that will be monitored and controlled by a non-profit entity. According to reports, the new database is expected to save patients money in the long term. The Ingenix database will be shut down.
For more information, check out these articles from the New York Times, Associated Press and CBS News.