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MedCity morning read, Tuesday, Feb, 10

The American Medical Association announced today it joined with state medical associations on the East Coast and the South to sue Aetna Health and CIGNA, saying the two health-insurance companies dramatically under-reimburse physicians.

The American Medical Association announced today it joined with state medical associations on the East Coast and the South to sue Aetna Health and CIGNA, saying the two health-insurance companies dramatically under-reimburse physicians, according to a press release.

The lawsuits were filed Monday in New Jersey federal court – here’s the complaint against Aetna and the other against CIGNA (both pdf files) – and claim that for more than a decade the businesses “used a corrupt system to underpay physicians for out-of-network medical services and forced patients to pay an excessive portion of the costs.”

The AMA’s ire is focused on how the companies used data provided by Ingenix, a subsidiary of UnitedHealth Group, to set reimbursement rates for out-of-network care. New York Attorney General Andrew Cuomo investigated Ingenix and said the company “dramatically under-reimbursed their members for out-of-network medical expenses by using data provided by Ingenix.”

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The Connecticut State Medical Society, Medical Society of New Jersey, Medical Society of the State of New York, North Carolina Medical Society and Texas Medical Association joined the AMA in the lawsuit.

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