Cigna Settles With New York Over Out-of-Network Reimbursemen

 

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18 February 2009 Wednesday 02:10 PM EST

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Cigna Settles With New York Over Out-of-Network Reimbursement

Fran Lysiak

PHILADELPHIA



Cigna Corp. will stop using the database maintained by Ingenix and pay $ 10 million to a nonprofit organization that will establish a database to determine the reimbursement rates for members at the visit doctors in its network as part of a settlement with the Attorney General of New York.

Cigna is the latest insurer to settle with the Attorney General Andrew Cuomo, who launched an industrywide probe of non-network reimbursement rates, a year ago. In recent weeks, UnitedHealth Group (NYSE: UNH) and Aetna (NYSE: AET), other insurers, the agreements, the agreement to contribute $ 50 million and 20 million respectively, at the non-profit organization.

The Attorney General of the investigation centered on Ingenix, a database of billing health from UnitedHealth. The database, which most insurers use to determine their rate of usage, consumers duped by "hundreds of millions of dollars," Cuomo alleged. The agreement with Cigna is the last domino to fall in our scanning industrywide health care and reimbursement system that brings us another step toward comprehensive reform, "Cuomo said in a statement.

Cigna (NYSE: CI) said the new nonprofit organization, will help individuals get "Transparency and accurate information on costs of care they receive. Cigna" commends the Attorney General in his efforts to introduce greater transparency in the pricing of health care services, and we are pleased to participate in the creation of an independent, non-profit organization to manage the new database, "said Dan Nicolls, North Cigna Medical Director the region, in a statement.

Smaller insurers also concluded agreements with the Attorney General relating to the use of databases of Ingenix. Earlier this month, the MVP Health Care non-profit has become the first New York State's health insurance and was set to pay $ 535,000 over five years to help fund the new database (BestWire, Feb. 6, 2009).

Subsequently, Cuomo's office said it signed agreements with the independent health and HealthNow New York Inc., two Buffalo-area businesses, non-profit.

Aetna and Cigna Healthcare offers separate class-action court recently by the American Medical Association, state medical societies and physicians alleging they used the Ingenix data from more than a decade to underpay physicians strongly that are outside their networks (BestWire, Feb. 13, 2009).

Last month, UnitedHealth reaches $ 350 million settlement of class action suits filed by the AMA, state medical societies, health care providers and health plan during the same issue (BestWire, Jan. 15, 2009).

Cigna HealthCare companies currently have Best's Financial Strength Ratings of A-(Excellent).

(By Fran Lysiak Matso, senior editor, BestWeek: fran.lysiak @ ambest.com)

19 February 2009

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