Database Settlement Expands Scope
Health insurers are facing the costs of underpaying patients for out-of-network care. Last Tuesday, UnitedHealth Group settled an investigation by New York State Attorney General Andrew Cuomo that alleged the company's database was miscalculating reimbursement rates for patients who used out-of-network doctors. UnitedHealth agreed to pay $50 million to fund an independent database, which will be run by a non-profit group.
The case expanded last Thursday when UnitedHealth settled a class action suit filed by the American Medical Association for $350 million, according to reports. The suit raised similar questions about the allegedly faulty database.
On the same day, Aetna agreed to pay $20 million for using the database. The money will be added to UnitedHealth's $50 million to help finance the new database. Hundreds of other insurers have used the database to calculate payments, reports said.