Tuesday, March 31, 2009

The Ingenix saga continues

I watched the testimony of the United Healthcare Group CEO and the Ingenix CEO before the Senate Commerce Committee today. They gave sound reasons to support the validity of the Ingenix usual reasonable and customary (UCR) database, but the Chairman Sen. Jay Rockefeller was swayed by the American Medical Association's testimony. I think that UHC and Ingenix placed themselves in a difficult situation by settling with the NY Attorney General and the American Medical Association for over $400 million. As Sen. McCaskill put it, and I'm paraphrasing here, "why would you pay that much money if you hadn't done anything wrong." However, as a lawyer, I know that, as Kenny Rogers put it so well, you have to know when to hold em and know when to fold em. In any event, the Chairman, Sen. Jay Rockfeller, was "profoundly" troubled by today's testimony and plans to inquire of health plans outside New York State whether they plan to use the new database being established under the Ingenix settlement agreement with the New York attorney general. Ingenix has placed its health plan customers in a difficult position. And as I have said before, it's not a fraud; the winners are the out of network doctors and the losers are the health plan members and doctors who play by the rules. This ongoing investigation will only increase health insurance premiums.

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