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"We can no longer ignore improper business practices of health insurers who decide to play by their own rules without regard to patients or the legitimate costs required to care for them," is the quote from Dr. Nancy H. Nielsen, president of the AMA. The AMA is claiming that the two insurance providers have short changed the doctors of out of millions of dollars of out of network healthcare. Several insurers, including Aetna have already agreed to pay millions in settlements to the NY Attorney General's investigation in this matter; however none of that money is going towards restitution for the physicians lost wages. This money has been set aside to create a new database to replace the one run by Ingenix, a UnitedHealth Group unit that is known to be problematic. The Ingenix systems is being accused of skewing data that is collected on what is considered "reasonable and customary" to pay physicians who do not participate in their networks. Cynthia Michener, a spokeswoman for Aetna, said her company is "disappointed the medical community has chosen to litigate on top of already pending consumer litigation on the topic."
She added: "Both members and providers cannot be paid for the same claim under these cases. Ultimately, increasing health care costs increases the number of uninsured and the cost of health care for everyone." I guess one need's to wonder if the insurance companies had been responsible to begin with if they would have felt the need to release in a statement that they "WILL" be passing on that cost to the doctors and patients. They will need those millions of dollars that weren't paid to the doctors for the legal fees, and PR to remind us how much we need "Big Insurance" to take care of us, right?
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