Oh what a tangled web we weave . . . remember learning that as a child?  Well, here are some of the largest, biggest names in health insurance working diligently to devise a system essentially designed to deceive.   Deceive providers, patients, premium payers and so on.  All in the name of exaggerated profits for so called health insurance entities.  The practices are a stain on the many legitimate persons working in the health insurance industry who are trying, within the constraints that exist, to make coverage more affordable and accessible.  A rose by any other name is still FRAUD AND BAD FAITH (a phase insurers hate) . . . obi jo

Aetna agrees to $20 million settlement in reimbursement system probe. 

Health insurer Aetna, Inc. said Thursday it will pay $20 million to help set up a database to calculate out-of-network medical payments in an effort to end a dispute with UnitedHealth Group, Inc. over a system that allegedly passed more costs to plan members.” Working with the office of New York Attorney General Andrew Cuomo, under the agreement, Aetna is expected to “set up an independent public database,” as well as “a system to help plan members find out what they will have to pay out of pocket before they visit a doctor who is not part of Aetna’s network.”

 Aetna said it has been working cooperatively with the attorney general’s office over several months to share its processes for determining out-of-network claim payments and to provide insight into the Ingenix database.  The insurer is expected to contribute “to the nonprofit group in installments for a period of up to five years.” The nonprofit “will serve as the sole arbiter and decision maker with respect to all data contribution protocols and all other methodologies used in connection with the database.”

read more @ http://www.forbes.com/feeds/ap/2009/01/15/ap5927070.html 

and

http://money.cnn.com/news/newsfeeds/articles/djf500/200901151330DOWJONESDJONLINE000962_FORTUNE5.htm