The American Medical Association has added WellPoint, Indianapolis, to a growing list of companies targeted with class-action lawsuits seeking payback for several years of out-of-network reimbursements allegedly held artificially low.
In a complaint filed in U.S. District Court in Los Angeles, mirroring ones filed in New Jersey against Aetna and Cigna Corp., the AMA argues WellPoints use of data purchased from UnitedHealth Group subsidiary Ingenix amounted to a price-fixing scheme driving low payments to physicians when patients sought care outside their provider networks.
WellPoint is committed to providing appropriate reimbursement for out-of-network services, according to an e-mailed statement from a WellPoint spokeswoman. We are in the process of reviewing the complaint and are unable to comment further at this time.
In January, the AMA secured a $350 million settlement from UnitedHealth in a similar lawsuit. That same week, New York Attorney General Andrew Cuomo reached an agreement with UnitedHealth requiring the company to discontinue the database products at issue.
Serious damages resulting from prior use of the Ingenix database still need to be addressed, AMA President Nancy Nielsen said in a news release.
Cuomos office also secured agreements with Aetna, Cigna, UnitedHealth and WellPoint and other health insurers compelling them to stop using the Ingenix data to calculate out-of-network reimbursements and to contribute payment data and money to his effort to replace it.