Today’s Washington Post has a story about how the health insurance companies deciced on how much they would pay policy-holders for visits to out-of-network physicians based in a “customary” charge that was calculated by the insurance industry.
They routinely shortchanged policy-holders by nearly 30 percent, costing consumers billions.
The practice was detailed today in a US Senate Finance Committee report. According to the Post:
” As it turns out, insurers typically used numbers from Ingenix Inc., which was a wholly owned subsidiary of the big insurer UnitedHealth Group. As such, Ingenix had an incentive to produce benchmarks that low-balled usual and customary rates and shifted costs from insurers to their customers, the report said.
“Making matters worse, Ingenix got all of its data from the same insurers that bought its benchmark information, the report said. Insurers that contributed data to Ingenix often “scrubbed” their data to remove high charges, and Ingenix further manipulated the numbers, removing valid high charges from its calculations, the report said. ”
New York Attorney General Andrew Cuomo described it last year as “a scheme by health insurers to defraud consumers by manipulating reimbursement rates.” A dozen insurers have reached settlements with Cuomo agreeing to change their practices.
But, really, we can trust them with our health care system.
Read the entire story here:
Post a comment