January 26, 2009 – New York Attorney General Andrew Cuomo rocked the United States’ healthcare industry earlier this month after announcing that Ingenix, Inc., was providing faulty information to the nation’s largest healthcare insurers. After an investigation into UnitedHealth Group’s- the parent company of Ingenix, Inc.- reimbursement process for out-of-network medical services, Cuomo discovered that UGH was defrauding customers by setting artificially low rates for patients, and therefore leaving them to foot most of their medical bills. Cuomo charged Ingenix, Inc., the nation’s largest healthcare billing information provider, with falsifying and manipulating their database. The exploitation of their database had catastrophic effects because many of the nation’s largest healthcare insurance firms use the information provided by Ingenix, Inc. to determine reimbursement rates for out-of-network care. The Attorney General is still investigating the extent to which the insurance industry as a whole is involved. Currently, Cuomo has issued 16 subpoenas to the country’s largest health insurance providers including: Empire BlueCross Blue Shield, CIGNA, Aetna, as well as UnitedHealth Group and three of its subsidiaries.

As of current, Cuomo has not sued the company as he is investigating, in his words, “[an] industry-wide scheme perpetrated by some of the nation’s largest health insurance companies to defraud consumers.” UnitedHealth Group has recently consented to pay $350 million to reimburse patients as settlement and terminate the lawsuit. However, some feel a more personal attack by Ingenix, Inc. Jeffrey Wientraub of Connecticut is rallying for a class action suit against Ingenix, Inc. itself. Only time will tell the extent to which the health insurance industry has been infiltrated and the futures of both UnitedHealth Group and the nation’s health insurance industry as a whole.

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