The New York attorney general Andrew Cuomo is broadening his investigation into health insurers’ practices related to payments for out-of-network services.
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.
