Cuomo presses insurers for payment info

The New York attorney general Andrew Cuomo is broadening his investigation into health insurers’ practices related to payments for out-of-network services.
MAR 07, 2008
New York Attorney General Andrew Cuomo is broadening his investigation into health insurers’ practices related to payments for out-of-network services, issuing new subpoenas to several companies seeking additional information. Mr. Cuomo last month announced plans to sue Minnetonka, Minn.-based UnitedHealth Group Inc. and several of its subsidiaries for dramatically under-reimbursing out-of-network medical expenses using data provided by Eden Prairie, Minn.-based Ingenix, also a unit of UnitedHealth. No suit has yet been filed. In addition, he issued subpoenas to several other large health insurers, including Aetna Inc., CIGNA Corp. and WellPoint Inc., and he has now issued new subpoenas to those companies, as well as UnitedHealth, seeking all e-mail correspondence involving the companies’ chief executive officers, chief operating officers, chief financial officers, presidents and employees supervising claims. Mr. Cuomo also is subpoenaing any records that might challenge the accuracy of reimbursements that he feels are too low. Mr. Cuomo also is reviewing the testimony already received from the CEOs of those and several other insurers including Empire Blue Cross Blue Shield, Excellus and the combined Group Health Inc. and HIP Health Plan. Mr. Cuomo’s investigation centers around Ingenix’s Prevailing Healthcare Charges System, which is used by most of the nation’s health insurers and third-party administrators to calculate out-of-network reimbursements to providers based on usual, customary and reasonable charges. The attorney general asserts that because the reimbursement rates were set too low, consumers were forced to pay higher than necessary out-of-pocket medical expenses.

Latest News

Merrill lands four advisor teams as May recruiting data shows firm's two-way churn
Merrill lands four advisor teams as May recruiting data shows firm's two-way churn

Merrill's latest hires span Colorado to Louisiana, even as industry-wide recruiting data suggests the firm is losing almost as many advisors as it gains.

Fund manager sues Kandeo, alleges $100 million FinSocial loss
Fund manager sues Kandeo, alleges $100 million FinSocial loss

The $36 million buy allegedly hid inflated books and a $50 million diversion.

Advisor gets $200,000 from Ameriprise in 'emotional distress' lawsuit
Advisor gets $200,000 from Ameriprise in 'emotional distress' lawsuit

“An award citing emotional distress is very unusual,” an industry executive said.

Workplace financial education linked to stronger financial habits, but participation remains low
Workplace financial education linked to stronger financial habits, but participation remains low

New EBRI research found workers who participated in employer financial education reported higher confidence, literacy and financial satisfaction.

The rise of the super advisor: How AI is redefining competitive advantage in wealth management
The rise of the super advisor: How AI is redefining competitive advantage in wealth management

Beyond operational excellence, the winning advisors of the future are the ones who can reach across multiple disciplines without discarding specialist skills.

SPONSORED Direct indexing webinar targets tax-loss harvesting amid market swings

Northern Trust’s Ken Lassner shows advisors how to convert volatility into after-tax portfolio gains

SPONSORED Who builds the income when the pension disappears?

Dan Biagini of American Equity says the steady decline of pensions, longer lifespans and a reset in interest rates are rewriting how advisors build retirement income