US Senator Rails Against UnitedHealth

Democrat Senator Jay Rockefeller made the news recently when he criticized UnitedHealth Group, the nation’s highest-grossing health insurer. The gist of the senator’s criticism focused on the insurer’s apparent act of collusion. He accused the company of paying less for health care services offered outside of its operating network.

Senator Rockefeller is the current chair of the Senate Commerce Committee intends to bring the matter before a Congressional hearing. Rockefeller means to shed light on UnitedHealth’s past billing practices involving those patients who are not a part of its network.

According to other reports, UnitedHealth made a settlement with the New York attorney general’s office earlier this year to deal with charges that its subsidiary company, Ingenix Inc., created fraudulent billing rates. These rates underpaid hospitals and doctors for out-of-network care. Rockefeller stated that this would mean that patients would have to exorbitant amounts for these procedures than they would have within the insurer’s coverage area.

Based on the terms of the settlement, UnitedHealth will pay $50 million toward a new non-profit research organization tasked with developing efficient patient date delivery and help determine prices for out-of-network care.

Senator Rockefeller urged that Ingenix should be dismantled within six months to make room for the non-profit alternative so it can begin calculating rates to pay hospitals and physicians.

While different insurers involved with the Ingenix settlement may still be free offer their own systems for calculating rates on reimbursements, there remain worries that further problems down the road.

The senator was adamant in his hope that the committee would take a stronger hand in the effort to provide better oversight. This might mean focusing on areas like reimbursement rates for out-of-network services, no matter the insurer’s level of involvement in the Ingenix settlement.

Rockefeller made the following statement, which he hoped would be heard widely. “We just want the statement to go out there to all other states and all other areas that you can’t do this.”