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UnitedHealth to pay $350M in reimbursement suits

By Darla Mercado
January 16, 2009, 1:20 PM EST
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UnitedHealth Group has reported that it will pay $350 million to settle three class actions related to out-of-network reimbursements.

One of the suits was brought in federal court in New York by the Chicago-based American Medical Association, which led medical societies, health plan members and medical-care providers against the carrier.

The settlement releases Minneapolis-based UnitedHealth and its affiliates from claims related to its out-of-network reimbursement policies through the date of the final court approval of the settlement.

The company didn’t admit any wrongdoing as part of the settlement.

News of the carrier’s settlement follows its settlement with New York Attorney General Andrew Cuomo, who investigated UnitedHealth’s billing database, Ingenix, after allegations that customers were paying too much for out-of-network procedures.

As part of that agreement, UnitedHealth agreed that it will cease using Eden Prairie, Minn.-based Ingenix and float $50 million toward an independent non-profit database that will allow customers to compare prices for out-of-network procedures.

Additionally, Aetna Inc. of Hartford, Conn., which also used Ingenix, agreed to contribute $20 million toward the new data source.



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