Two-Thirds Of Insurers Share Faulty Database That Lets Them Overcharge Patients

Earlier this week, a Congressional investigation revealed that several insurance companies rely on a database from Ingenix that deliberately underestimates the cost of medical services, reports the Associated Press. The result is that “American consumers have paid billions of dollars for health care services that their insurance companies should have paid.”

More than 100 million Americans have plans that allow them to see doctors who are not part of their insurance network. For more than a decade, insurers submitted data to Ingenix to determine the typical cost for care received outside their networks.

But congressional investigators say companies would deliberately skew data to underestimate the costs of medical services, leaving patients to pay more in out-of-pocket expenses.

[...]

In one case, Aetna allegedly eliminated the highest 20 percent of medical charges before sending the data to Ingenix, according to expert court testimony cited by congressional investigators. Once the data was handed over to Ingenix, officials there “scrubbed” the numbers again to further curb charges, according to the testimony.

Ingenix is owned by UnitedHealth Group, which the Associated Press says has admitted no wrongdoing but has agreed to close the database and fund a new one.

“Senator: Use of faulty insurance data ‘pervasive’” [Associated Press]
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