Physician-ranking programs by Aetna and Cigna Healthcare may confuse or deceive consumers because of how they are designed, New York Attorney General Andrew Cuomo has warned in letters to the two insurers. Cuomo requested full justification for the programs, which recommend certain primary-care physicians and specialists to consumers. His office wrote that Aetna Aexcel and the Cigna Care Network may be flawed because the insurers rely on claims data that may exclude key information and have too small a sample size to yield useful data. The insurers did not disclose ranking data, according to the letters. The goal of transparency is defeated if the information provided is itself inaccurate or misleading, or based on flawed data, wrote Linda Lacewell, counsel for economic and social justice at the attorney generals office, in the letters. Inaccurate physician rankings could cause financial harm to consumers because some employers steer workers to preferred doctors by lowering copayments, according to the attorney general's office. So workers who choose not to see preferred doctors could pay more. Insurers have a profit motive to steer consumers to cheaper doctors, not those who are most qualified, Lacewell wrote. Cynthia Michener, spokeswoman for Aetna, said in an e-mailed statement that the company will cooperate with the requests, and is fully committed to transparency, including publishing the criteria for the selection of specialty physicians on our member and provider Web sites. In July, Cuomo instructed UnitedHealthcare not to introduce its physician ranking program in New York state without his prior approval; the program was scheduled for an October rollout.
N.Y. scrutinizing insurers rankings of physicians
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