Practice Management Alert

New York Attorney General Andrew Cuomo announced plans to file suit against UnitedHealth Group, stating that the company is committing consumer fraud in how it sets rates for paying out-of-network physicians. Cuomo says that by setting the "reasonable and customary" rates used to pay non-network doctors at an artificially low level, UHG unfairly burdens consumers with large balances.

- Assemblyman Hector De La Torre (D) introduced a bill in California that would require health insurers to get permission from state officials before retroactively canceling a beneficiaries- coverage. If the bill passes into legislation, health plans will need to get prior approval from California's Department of Managed Health Care before canceling or rescinding a member's policy. This bill followed controversy over letters issued by Blue Cross of California. The letters asked physicians to seek out and report any pre-existing conditions or discrepancies the payer could use to disqualify patients from coverage.

- In January, Blue Cross and Blue Shield of Massachusetts announced a payment plan -- the Alternative Quality Contract -- combining a fixed per-patient, per-year payment per patient, adjusted patient health, and performance incentives tied to national quality measures.