Following the lead of other insurers, including Cigna, UnitedHealth and Aetna, Health Net has agreed to stop using an Ingenix database commonly used by health plans to set out-of-network reimbursement rates for physicians.
As part of the settlement with New York Attorney General Andrew Cuomo, who dragged the other insurers into similar agreements, Health Net will contribute $1.6 million toward a new, independent database of out-of-network rates. A total of twelve insurers have agreed to new rules established by Cuomo.
In so doing, Health Net is actually getting away cheaply. Aetna, for example, was assessed a $5.1 million fine to settle charges that it had systematically underpaid physicians; it also paid in $20 million to establish the non-profit organization that will run the new database. UnitedHealth has agreed to pay in $50 million toward the database.
To learn more about the settlement:
- read this Modern Healthcare piece
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