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Settlement Reached Between UnitedHealth Group Inc. and New York State Attorney General

January 13, 2009 UnitedHealth Group Inc. settled with the New York State Attorney General Andrew Cuomo after a probe of the independence of its database used to set reimbursement rates for patients’ medical bills. The probe found that Ingenix operates a ‘defective and manipulative’ database used by major health insurers to set reimbursement rates for out-of-network medical expenses. The Ingenix skewed rates downard compared to the market rates which would shortchange the consumers. In Cuomo’s yearlong investigation, he found that consumers across the country had paid more than they should have for out-of-network services through skewed patient reimbursement rates. He believes that the overcharges to consumers could range in the hundered of millions of dollars.

The settlement forces UnitedHealth to shut down its Ingenix medical billing service and pay $50 million toward starting a new independent database to determine market rates for healthcare procedures. The agreement contains no admission of wrongdoing. Cuomo is waiting on the outcome of current lawsuits filed by other parties before his office takes its own actions to pursue restitution.

About the <span>Author</span>

About the Author

Tom D'Amore is the founder of D'Amore Law Group and a trial attorney with over 30 years of experience representing injured people and their families across the West Coast, securing more than $325 million in recoveries. He handles cases involving car accidents, trucking accidents, construction injuries, medical malpractice, and sexual abuse. Licensed in Oregon, Washington, and California, Tom is the only NBTA board-certified truck accident attorney in Oregon. He is a national Board of Governors member, past Executive Committee member, and past Budget and Audit Chair of the American Association for Justice, as well as past President of the Oregon Trial Lawyers Association and an Eagle member of the Washington State Association for Justice.
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