Under the agreement, both companies will stop using the Ingenix database system and will reprocess out-of-network claims and reimburse consumers where needed. The two companies will also contribute money towards the development of a new database to determine fair out-of-network reimbursement rates.
This agreement is part of Mr. Cuomo’s mission to end industry-wide conflicts of interest in determining out-of-network reimbursement rates. Mr. Cuomo previous reached agreements with Wellpoint, CIGNA Corp. and UnitedHealth Group.
Read about Mr. Cuomo’s agreement with Excellus and CDPHP.
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