More Ingenix Fallout

Healthcare IT News, among other sources, reports that the American Medical Association and other medical societies have sued Aetna and Cigna over their use of the Ingenix usual, customary, and reasonable databases. Last month, Ingenix and its parent United Healthcare settled a lawsuit brought by the AMA and resolved a New York Attorney General investigation by agreeing to pay $50 million for the creation of an “independent database” to replace their commercial databases and to create a settlement fund of $350 million. Aetna agreed with the New York AG to kick in an additional $20 million toward the creation of the independent data base.

The AMA clearly is smelling blood in the water.  Karen Ignagni, President and CEO of America’s Health Insurance Plans, issued the following statement today in response to the lawsuit by the American Medical Association on out-of-network charges: “With the nation facing the crushing burden of rising medical costs, all stakeholders should be focusing on constructive ways to bring costs under control.  This lawsuit moves in the opposite direction by advocating to give providers who refuse to participate in networks a ‘blank check’ to charge patients rates that exponentially exceed Medicare payments.  It is the responsibility of policymakers to carefully scrutinize how much consumers are being asked to pay.”  Amen to that.