WellPoint Inc. agreed to pay $10 million to
settle an investigation by New York Attorney General Andrew Cumo into
questionable insurance reimbursements in the state.
WellPoint is the parent company to Anthem
Blue Cross and Blue Shield in Wisconsin
and one of the largest health insurers in the state.
In the past 6 months, WellPoint has been
working with the Centers for Medicare and Medicaid Services in order to resolve
issues identified as a result of the company's internal compliance audits and
findings from a recent CMS audit.
In January, Cuomo reached a deal with United
Healthcare, under which the database will close. United Healthcare also pledged
to pay $50 million to a nonprofit that will establish a new, independent
database to help determine out-of-network rates. The measure was followed by
the attorney general’s decision to struck deals with other large insurers,
including Aetna, Cigna, and MVP Health Care. Under
the agreement, they decided to cease using the Ingenix data and contribute to
the new database.
“WellPoint is committed to appropriately
processing claims and fairly reimbursing health-care providers,” WellPoint said
in a statement.
On a national level, WellPoint covers more
than 35 million people. WellPoint has about 472,000 Medicare Advantage members
and 1.9 million Medicare Part D members, as well as 836,000 members who get
insurance to supplement their government Medicare plans.
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