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Life Health > Health Insurance > Your Practice

Cuomo Raises $20 Million For Physician Rate Database

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CIGNA Corp. and WellPoint Inc. have agreed to contribute $10 million each to helping to start a service that will replace the Ingenix physician fee service.

New York Attorney General Andrew Cuomo has announced that he has negotiated settlements with CIGNA, Philadelphia, and WellPoint, Indianapolis, in connection with New York allegations that a popular out-of-network health reimbursement database, the Ingenix database, was run in such a way that the database rates were significantly lower than the rates charged in the real world.

Cuomo says he now has persuaded health insurers to provide a total of $90 million in Ingenix replacement service funding through Ingenix-related settlements.

UnitedHealth Group Inc., Minnetonka, Minn., a health insurer, owns Ingenix.

Dr. Jeffrey Kang, chief medical officer at CIGNA, and Kenneth Goulet, an executive vice president at WellPoint, said their companies now agree with assertions that use of the Ingenix pricing data involves inherent conflicts of interest.

“CIGNA commends the attorney general’s efforts to bring greater transparency to the pricing of health care services and we are pleased to partner in the creation of an independent not-for-profit organization to administer the new database,” Kang says.

“WellPoint is committed to appropriately processing claims and fairly reimbursing healthcare providers for covered services under the terms of each member’s contract, while at the same time protecting our members and group customers against excessive charges by some non-participating providers,” Goulet says in a statement of his own. “WellPoint acknowledges the conflicts of interest in the Ingenix database which the attorney general’s investigation brought to light, and we support his efforts to increase the transparency of health care costs.”


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