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Attorney General Cuomo Announces Independent Reimbursement Rate Company

by Fred Mogul

NEW YORK, NY October 27, 2009 —New York's Attorney General announced the creation of a new non-profit company that he says will make it easier for patients and doctors nationwide to predict what they'll get from insurers. WNYC’s Fred Mogul has more:

REPORTER: If you use in-network doctors they and your insurer work out in advance what they get paid and what it costs you. But if you go out-of-network, insurers pay doctors a chunk of the so-called “usual and customary rate,” and you pay the rest. But that can be anyone's guess. Attorney General Andrew Cuomo says a company called Ingenix has basically been colluding with every major insurance carrier in the country to set those rates. Today, he announced that a non-profit will now set the rates nationwide, as part of a settlement with several insurers – including Ingenix’s parent company, United Health Group. The newly created company is to be called “Fair Health.” It will operate as a consortium among several upstate universities, including Syracuse, Cornell and SUNY-Buffalo. For WNYC, I’m Fred Mogul.


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