The United States District Court for the Southern District of New York has granted preliminary approval of a $350 million settlement in a lawsuit that the American Medical Association and two state medical societies filed against health insurer UnitedHealth Group.
The suit is one of at least four the AMA and several societies have filed against insurers that used databases from Ingenix Inc. to price out-of-network claims. Ingenix is a subsidiary of Minneapolis-based UnitedHealth Group. Suits also were filed against Aetna, Cigna and WellPoint. The suits alleged that the insurers conspired to underpay physicians for out-of-network services.
At least 10 national or regional insurers have reached agreement with New York Attorney General Andrew Cuomo to stop using the Ingenix databases and contribute a total of nearly $100 million to fund creation of an independent national database to process out-of-network claims. Cuomo charged the database intentionally skewed downward the "usual and customary" rates on which reimbursement was determined.
Under the AMA's settlement with UnitedHealth Group, the insurer will set up a $350 million fund to reimbursement members of the class action lawsuit.
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