In an addition to an earlier post, we note that UnitedHealth has been forced to end its incestuous relationship with Ingenix which clearly benefited the insurer at the expense of providers and ultimately patients.  Once again we find evidence that so called “health insurers” are in reality “health insurance arbitragers” out to maximize profit by denying, delaying, and underpaying just claims for provider services.  We again call on the new administration to read The  Plan as outlined at this site and adopt all, or at least most of our ideas about health insurance reform . . . jomaxx

UnitedHealth agrees to pay $50 million to settle billing fraud allegations

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 agreement resolves an investigation by New York Attorney General Andrew Cuomo (D) into allegations that the database, run by UnitedHealth subsidiary Ingenix intentionally skewed rates lower through faulty data collection . . . read more @ http://www.usatoday.com/news/health/2009-01-13-unitedhealth_N.html

 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. Under the settlement, “a nonprofit entity will provide data on ‘reasonable and customary’ costs that insurers use to set reimbursement rates to patients. 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 . . . read more @ http://www.bloomberg.com/apps/news?pid=newsarchive&sid=a13QfOKQMTQs

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 (AMA) stated . . . read more @ http://www.chicagotribune.com/business/chi-biz-united-healthcare-scheme-jan13,0,6282629.story      

Commenting on the settlement, AMA President Nancy Nielsen, M.D., said that insurers can drive a wedge between doctors and patients when they underpay medical bills. She added that with the new database, “people will know what they’re getting, and it will be clear and transparent . . . read more @ http://www.nydailynews.com/news/2009/01/13/2009-01-13_ag_andrew_cuomo_reins_in_health_care_gia.html