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Senate Probe Uncovers Major Underspending by Several Payers

Published on Fri Nov 20, 2009

Plus, Georgia insurance commissioner slaps UHG with hefty fines for payment delays. A U.S. Senate probe confirms what many coders and billers have been suspecting all along -- that six major medical insurers aren't spending as much as they should providing actual health care. The payers in question include Aetna,Cigna, Coventry Health Care, UnitedHealth Group, Humana, and Wellpoint. Insurance industry officials say that all insurers spend an average of 87 cents of every dollar on medical care, according to an article in The Wall Street Journal. "The [Senate] report singles out Cigna, saying that it failed to report $5 billion in small group and large group insurance business to state regulators and instead reported it as 'other group' business," says the Journal. America's Health Insurance Plans (AHIP), which provided the 87 cents figure, released a wordy statement that let the large insurers off the hook -- saying, basically, that the chunk of [...]
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