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.