NY AG: New Not-For-Profit Co To Develop Health Insur Database
27 Octubre 2009 - 9:33AM
Noticias Dow Jones
New York Attorney General Andrew Cuomo on Tuesday announced the
creation of a new not-for-profit company to help establish an
independent database to help determine the rates that health
insurers pay doctors and hospitals out of their networks.
The company, to be called Fair Health Inc., is an outgrowth of
Cuomo's probe into a controversial database that was maintained by
UnitedHealth Group Inc.'s (UNH) Ingenix unit and used by the
industry to determine the "usual and customary" rates for medical
procedures in an area.
Fair Health will work with a group of upstate New York research
universities and will use nearly $100 million in settlement moneys
to develop the new database, Cuomo said. The schools are Syracuse
University, the State University of New York at Buffalo, Cornell
University, the University of Rochester and SUNY Upstate Medical
University.
The company also will maintain a Web site that allows consumers
to check out-of-network reimbursement rates for potential
procedures, Cuomo said.
"When you go to the doctor's office, there will be no
surprises," Cuomo said.
Creation of the not-for-profit company was unveiled at a press
conference at Syracuse University Tuesday.
Research for the new database will be centered at Syracuse
University's Maxwell School and its School of Information Studies,
Cuomo said.
The attorney general had alleged that the Ingenix database
skewed the "usual and customary" rates in an area downward through
faulty data collection, poor pooling procedures and lack of audits,
thus forcing consumers to pay more out of their own pockets for
health care.
In January, UnitedHealth agreed in a pact with Cuomo's office to
shut down the Ingenix database and pay $50 million to establish a
nonprofit group to run the new database.
Cuomo has reached agreements with health insurers who serve New
York state to provide about $100 million to establish a nonprofit
group to run the database, including WellPoint Inc. (WLP), Aetna
Inc. (AET) and Cigna Corp. (CI).
Last year, Cuomo threatened to sue UnitedHealth over the
database and issued subpoenas to a number of health-insurance
companies that use it, including Aetna, Cigna and WellPoint's
Empire Blue Cross Blue Shield.
-By Chad Bray, Dow Jones Newswires; 212-227-2017;
chad.bray@dowjones.com