The American Medical Association (AMA) is suing WellPoint, Aetna Health, and CIGNA -- which all provide dental as well as medical insurance -- alleging that they used a flawed database to reduce their reimbursement for out-of-network physicians, the organization has announced.
The AMA lawsuit follows on an investigation by New York Attorney General Andrew Cuomo that concluded the Ingenix database "skewed 'usual and customary' rates downward through faulty data collection, poor pooling procedures, and the lack of audits," Cuomo's office stated in a press release.
UnitedHealth, which created the database, had a conflict of interest because it is in the insurance business, Cuomo determined. UnitedHealth, Aetna, WellPoint, and CIGNA have agreed to fund an independent database to be operated by a nonprofit organization, according to Cuomo.
But the AMA and other medical associations still want the insurers to compensate them for past low reimbursements, the AMA said.
Copyright © 2009 DrBicuspid.com
