Finkelstein Thompson LLP is investigating allegations that major health insurers fraudulently lowered the reimbursement rates to out-of-network physicians, thereby increasing the costs to patients who use such physicians.  If you have incurred out-of-network medical expenses - including visits to doctors outside of your insurance plan’s network - you may have been a victim of this alleged fraud.

On February 14, New York Attorney General Andrew M. Cuomo announced that he was “conducting an industry-wide investigation into a scheme by health insurers to defraud consumers by manipulating reimbursement rates.” Attorney General Cuomo outlined the results of a six-month investigation, in which he determined that the database used by most major health insurance companies to set reimbursement rates for out-of-network medical expenses was “defective and manipulated.”  In particular, the insurance companies “dramatically underreimbursed their members for out-of-network medical expenses.”  These alleged underreimbursements would result in increased medical costs to patients using out-of-network doctors.

Attorney General Cuomo has indicated that he intends file suit against several companies, including Ingenix, Inc, its parent UnitedHealth Group (NYSE: UNH), and several subsidiaries.  Sixteen (16) other insurance companies - including Aetna Inc., Cigna Corp., Empire BlueCross BlueShield, and Humana - have been served with subpoenas in connection with this matter.

If you feel that you may have been victimized by this practice and wish to discuss your rights and interests in this matter, please contact our Washington, D.C. office toll-free at (877) 337-1050 or by email.