Entries from HEALTH LAW SECTION BLOG tagged with 'usual and customary'

AG's UCR Database Gets a Name: FAIR Health, Inc.

The Attorney General released some details of the promised state-sponsored database intended to replace the private Ingenix database of out-of-network pricing information: Attorney General Cuomo today [Oct. 27, 2009] announced historic nationwide reform of the consumer reimbursement system for out-of-network...

More Woe for Ingenix and Its Clients (Updated)

The Health Law Section listserve this afternoon broke a story on a new case filed April 29, 2008 against Ingenix, Inc. and a number of payors in Connecticut U.S. District Court. The additional defendants include UnitedHealth Group Inc, Oxford Health...

More on Ingenix: Massachusetts Case

Today at TheStreet.com Melissa Davis writes about a recent Massachusetts case that could provide a discouraging precedent for UnitedHealth: Three years ago, Dr. Michael Davekos set out to prove that he had been underpaid for treatment he provided to a...

AG Subpoenas More Insurer Records

Crain's New York Business online carried a piece this afternoon about a new round of subpoenas in the AG's investigation into "usual and customary rates" paid by insurers: Mr. Cuomo says he believes the companies used UnitedHealth Group subsidiary Ingenix...

Industry: Basic Premise of Cuomo's Rate-Scheme Investigation Questionable

Atlantic Information Services reprints an article from Health Plan Week on Attorney General Andrew Cuomo's ongoing investigation into health plans' use of "usual and customary rates" to pay for out-of-network care: A six-month investigation into rate-setting practices of health plans...

Cuomo to Sue UnitedHealth and Ingenix For "Manipulating Reimbursement Rates," Calls Ingenix a "Conduit For Rigged Data"

From the AG's website: Attorney General Andrew M. Cuomo today announced that he is conducting an industry-wide investigation into a scheme by health insurers to defraud consumers by manipulating reimbursement rates. At the center of the scheme is Ingenix, Inc.,...

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