Cigna Agrees to Quit Faulty Database and Donates $10 million
The Cigna Corporation has just announced that it will stop using a faulty database in order to calculate reimbursement rates for patients who see doctors outside of their insurance networks, also contributing $10 million to a new independent payment database.

This conflict of interest unfairly raised charges for people who went to see doctors outside of their network. For now, a class-action lawsuit against Cigna has not been settled, making it unclear whether it will reimburse customers who overpaid in the past. Cigna is one of the nation’s largest insurers and it is based in Philadelphia.

This Cigna settlement came on the same day New York’s attorney general, Andrew Cuomo, announced plans to sue Excellus Health Plan of Rochester, on charges of defrauding consumers by manipulating rates. This way, Cigna joins several other major insurers that have reached agreements with Mr. Cuomo in the nationwide push to reform how health care reimbursement rates are set.

As for this matter, Mr. Cuomo told the media the use of a database operated by Ingenix had helped set rates low so insurers could underpay out for out-of-network services. The investigation by the attorney general’s office revealed that the database had intentionally skewed rates downward, by as much as 28%.

As previously mentioned, Cigna agreed to contribute $10 million toward the creation of an independent database to determine reimbursement rates that will be transparent to patients and run by a non-profit organization. UnitedHealth also agreed to pay $50 million and Aetna agreed to submit $20 million. Furthermore, UnitedHealth also paid $350 million to settle a class-action lawsuit initiated in 2000 by the American Medical Association.




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