Cigna and Aetna face lawsuit – AMA joining the the cause on payment issues
Posted Feb 11 2009 3:49pm
It appears Ingenix is mentioned once more with the legal cases, but those cases are separate but with the same underlying issues of low payments made to the physicians for out of network charges. We also have the cases of balance billing in California that have also created a lot of havoc and problems for patients as well. It is a guessing game of sorts, who, what and how much will be paid, and not to mention the flurry of paperwork, time on the phone, etc. that goes along with the processes. BD
The American Medical Association is joining several state associations in suing health insurers Cigna Corp., of Philadelphia, and Aetna Inc.over a database they say was rigged to underpay doctors on out-of-network claims for more than a decade.
Doctors want compensation for the time they wasted asking the insurers for more money and for income they lost because of the low payments and the inability of patients to pay their share of the bills, said Lawrence Downs, general counsel for the Medical Society of New Jersey, one of the groups participating in the suit.
Patients who use doctors who are not in their insurance company's network typically are expected to pay whatever the insurer doesn't. Downs said Cigna and Aetna set their payments too low, leaving patients with a bigger share of the bill.
The lawsuits heap more criticism on data from Ingenix Inc. that already has cost Minnetonka, Minn.-based UnitedHealth Group Inc. $350 million to settle a separate lawsuit involving the AMA.