Bloomberg News
(1/15, Goldstein, Freifeld) reported, "UnitedHealth Group Inc., the
biggest U.S. health insurer, said it will spend $400 million to settle
allegations it has manipulated payments to doctors and patients for the
last 15 years." UnitedHealth "agreed to put $350 million into a
class-action restitution fund to pay physicians and policyholders for
services provided by out-of-network providers, the company said in a
statement today."
The Chicago Tribune
(1/16, Japsen) reports, "Score another one for better transparency in
understanding how much doctors get paid and what will be left for Joe
the Patient to pay out of his pocket." The AP (1/16, Murphy) also
covers the story.
Aetna settles suit, will pay $20 million. Bloomberg News
(1/15, Freifeld, Goldstein) reported, "Aetna Inc., the third-largest
U.S. health insurer, settled an investigation of reimbursement rates
for out-of-network doctors, New York Attorney General Andrew Cuomo said
in a statement." The agreement stipulates that Aetna is "to pay $20
million to a qualified nonprofit organization that will establish a new
database to help determine fair out-of-network reimbursement rates for
U.S. consumers, according to the statement." Cuomo said, ""With this
agreement, the tide is turning against the corrupted reimbursement
system that took hundreds of millions of dollars from the pockets of
patients nationwide" and "health insurers will no longer be able to
distort their data, leaving patients with unfair bills." Aetna's $20
million payment will be "added to the UnitedHealth payment to fund the
nonprofit database that will replace the Ongenix database."
UnitedHealth settlement sees challenge. The New York Times
(1/16, B3, Abelson) reports, "The insurance giant UnitedHealth Group
said Thursday that it had reached a $350 million deal to settle
class-action lawsuits claiming it had underpaid patients and doctors."
However, one of the lawyers for the plaintiffs said "the money is not
enough and has filed an objection with one of the judges overseeing the
cases." The attorney, "Barbara Quackenbos, whose firm is one of several
handling the cases on behalf of patients and doctors said, "We believe
the amount agreed to is inadequate and does not reflect as meaningful a
settlement as could be negotiated."
From the American Association for Justice news release.





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