Study: Ingenix data used throughout health plan industry

The Senate has looked into the face of the infamous Ingenix rate databases, and concluded that they are legion. A new report by the Senate Commerce Committee has concluded that the Ingenix database--used to determine out of network rates for physicians---is used by health plans nationwide.

UnitedHealth subsidiary Ingenix has already taken a pounding from New York Attorney General Andrew Cuomo, who struck a deal with the parent company in January requiring that it stop using two databases. Cuomo alleged the data was ridden with conflict-of-interest issues, since subscribing insurers provided the data and had an incentive to lowball the numbers.

Now Commerce Committee chair Jay Rockefeller (D-WV) is on the same trail. In March, he requested information from 18 health plans not doing business in New York. His staff found that almost all of them used Ingenix data. This includes plans in New Jersey, where the law requires that individual and small-business plans base their out of network rates on these databases.

To learn more about this investigation:
- read this Modern Healthcare article (reg. req.)

Related Articles:
Health Net will stop using Ingenix database
Aetna to pay $5 million over underpaid, out-of-network charges
UnitedHealth inks $50 million settlement with NY over Ingenix charges
NY sues UnitedHealth over MD payments

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