Practice Management Alert
AG Cuomo Hits Aetna, Excellus in Continuing Investigations
New York Attorney General Andrew Cuomo continues his year-long investigation of the insurance industry's handling of out-of-network medical costs. The latest insurance companies to feel the pain are Aetna and Excellus Blue Cross Blue Shield in New York. Aetna has agreed to pay more than $5.1 million to settle a suit charging that it underpaid more than 73,000 students on out-of-network costs under its Aetna Student Health subsidiary. Excellus agreed to pay out $1.7 million to help fund a new company that will create a new fee database. The company will also pay $775,000 to the Attorney General's office for investigation costs. The beneficiaries who may have been affected by lowered reimbursement may also resubmit their claims to Excellus for proper reimbursement. In January 2009, UnitedHealth Group and its subsidiary, Ingenix, agreed to pay $350 million to settle claims that it unfairly billed consumers. As part of that settlement, Aetna, which had used billing databases created by Ingenix, agreed to pay $20 million to establish a nonprofit body that would fairly determine out-of-network rates.
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AG Cuomo Hits Aetna, Excellus in Continuing Investigations
New York Attorney General Andrew Cuomo continues his year-long investigation of the insurance industry's handling [...]
