For a decade, the American Medical Association attacked the way insurance companies calculate what they pay doctors for out-of-network care. This year, UnitedHealth Group and its subsidiary Ingenix agreed to pull the plug on data sources that most of the industry has been using to calculate the reimbursements, a system the AMA argued was riddled with conflicts of interest and amounted to a price-fixing scheme.
Oh, NOW you want a lawyer
Who did the AMA make friends with in order to finally win this fight? Could it be SATAN?!
Not exactly. Just a more powerful lawyer than the doctors previously had at their disposalspecifically, New York Attorney General Andrew Cuomo, who launched a crusade a year ago against Ingenix and its customers and since January has been rolling out settlement agreements. On the heels of the first one, UnitedHealth agreed to pay doctors $350 million to settle a class-action lawsuit the AMA filed in 2000. Now the Senate Finance Committee is conducting an inquiry.
When AMA President Nancy Nielsen testified before the committee recently, Sen. Claire McCaskill, a Missouri Democrat, couldnt resist a bit of ribbing. I find it a little ironic that the Missouri Medical Association, the AMA, turned to Americas trial lawyers to right a wrong as it related to the way they were being reimbursed because, generally, when Im speaking to the members of the Missouri Medical Association, theyre explaining to me that Missouris trial lawyers are nothing short of Satan and that they are the evil that has cast such problems upon the practice of medicine that it makes it impossible for doctors to do their work.
And Nielsen, chuckling according to the transcript, replied: You bet. We dont hate all lawyers. We just havent had remarkable luck with the trial bar, as you know. The issue here was the factsunearthing the factsand having enough persuasive muscle to make sure that the flawed database was exposed and it took the muscle of the peoples lawyer. And so it did take a lawyer. It took the peoples lawyer. We are grateful for that.
And to that, McCaskill said: I dont mean to, you know, to pick on you. But I do think its important to note that even the American Medical Association, when they need a justice to be addressed, turn to Americas trial lawyers to try to get into court and fix a problem.
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