Health Care Giant Nailed for Fraud
MSNBC reports that United Health Group recently agreed to pay a $50 million settlement in the State of New York after an investigation of overcharging patients for their health care. Apparently, United Health used a research firm called Ingenix to set reimbursement rates. United Health owns Ingenix. How convenient. Several other health insurers use this same company to set medical bill reimbursement rates, and New York's Attorney general promises to investigate those companies as well.
Does this impact Oregonians and Washingtonians? Maybe. Many of the companies cited in the report provide health coverage in the Northwest, and the article mentions that this using this "creative research" to set reimbursement rates may be a nationwide problem. A lot of health plans are not really "insurance" in the strict sense. They are federally regulated by a statute called ERISA, although States may have some say in how the companies conduct business. A State Attorney General decides which companies to investigate, and how to pursue any fraud complaints. Oregon's Attorney General provides a web page for consumer complaints. For insurance issues, Oregon's Department of Consumer and Business Services Insurance Division accepts complaints on line.
I always encourage folks with a legitimate claim to file a complaint. If anything, it creates a record, and the state agency should see a red flag with several complaints against the same company.
Other Helpful Links:
