One of the nation’s largest health insurers was accused of overcharging millions of Americans for healthcare. The company, UnitedHealth Group, has agreed to pay a $50 million settlement after investigation by the New York State Attorney General’s office. The investigation arose after hundreds of patients complained to the state about medical care and procedures that were not being reimbursed as “usual, customary or reasonable” charges by UnitedHealth Group. UnitedHealth Group justified its withholding of coverage on the grounds that an “independent” company, Ingenix, had reviewed the care and treatment and deemed it outside the coverage. The investigation revealed that Ingenix is owned by UnitedHealth Group and therefore, questions were raised about the independence of its review process. Many of the patient are contemplating bringing a class action lawsuit against UnitedHealth Group.
Pierce & Thornton encourages you to review your health insurance company’s policies so that you are aware of covered and non-covered medical expenses.