Health insurers are again under scrutiny for billing practices as they buff their public image amid heated healthcare reform talks on Capitol Hill.
Insurers feel heat again
Hearing focuses on billing and marketing practices
Leaders of a key Senate committee last week blasted insurers for their use of Ingenix databases to price out-of-network physician claims. As of June 18, all 12 insurers operating in New York state have settled with state Attorney General Andrew Cuomo over the use of Ingenix databases, and agreed to participate in a new not-for-profit substitute.
But Sen. Jay Rockefeller (D-W.Va.), chairman of the Senate Commerce, Science and Transportation Committee, said in a new report that health insurers operating outside of New York are using faulty data from Ingenix, a UnitedHealth Group subsidiary, to price claims unfairly.
When insurance companies fail to meet their obligations to these people, it literally becomes a matter of life and death, Rockefeller said at a committee hearing.
The senator introduced a bill in May that would set federal standards for health insurance forms and tighter marketing rules for out-of-network coverage in group and individual health insurance markets. The bill would also establish a federal Office of Health Insurance Oversight to conduct compliance examinations and audits on insurers practices.
At a separate hearing convened by Rockefeller in March, UnitedHealth CEO Stephen Hemsley told the committee that Ingenix operates in a consistent fashion, to high standards of performance.
The star witness to testify before the committee last week was Wendell Potter, the former chief spokesman for Cigna Corp., and previously Humana. Potter said he is exposing how big for-profit insurers have hijacked our healthcare system and turned it into a giant ATM for Wall Street investors.
Now a senior fellow on healthcare for the Center for Media and Democracy in Madison, Wis., Potter told the committee that health insurers confuse their customers and dump the sick.
Rockefellers bill, as well as the creation of a public insurance-plan option are critical to making insurers accountable, Potter said. The industry and its backers are using fear tactics, as they did no 1994, to tar a transparent, publicly accountable healthcare option as a government-run system, Potter testified. But what we have today is a Wall Street-run system that has proven itself an untrustworthy partner to its customer, to the doctors and hospitals who deliver care, and to the state and federal governments that attempt to regulate it.
In response, Chris Curran, spokesman for Cigna and Potters replacement in the job, said in an e-mail that we strongly disagree with the suggestion that, motivated by profits, the insurance industry has deliberately attempted to confuse or unfairly treat covered individuals.
Send us a letter
Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.