Physicians groups in Connecticut and across the country are suing Aetna Health Inc. and Cigna Corp. for fraud for the way the insurers’ allegedly relied on a third insurer’s proprietary database to underpay out-of-network claims for patients.
The Connecticut State Medical Society joined the American Medical Association and several other state medical societies in filing class-action lawsuits Monday in New Jersey against both health insurers. The American Medical Association and medical societies in New York, New Jersey, North Carolina and Texas also are parties to the suit
The suit claims Aetna and Cigna used the Ingenix database owned UnitedHealth Group to “routinely and systematically underpay non-participating physicians who submitted claims for reimbursement for out-of-network services.”
“Physicians deliver the same quality care for their patients regardless of who their health insurance company is. It’s been a bitter pill for physicians to swallow, knowing that they were deliberately being underpaid to maximize corporate profits,” said Dr. William A. Handelman, president of the Connecticut State Medical Society said in a statement today.
Spokesmen for Aetna and Cigna vowed today both companies will vigorously defend themselves against this and other lawsuits pending from the Ingenix affair.
“We’re disappointed the medical community has chosen to litigate on top of already pending consumer litigation on the topic,” Aetna spokeswoman Michele Michener said in an e-mail.
Following an investigation by New York Attorney General Andrew Cuomo that revealed that Ingenix, based in Rocky Hill, intentionally manipulated data to shortchange patients, UnitedHealth agreed to a $50 million settlement and to replace Ingenix with an independent, nonprofit database for handling claims.
Aetna also settled, agreeing to contribute $20 million to formation of the same database.
Attorney General Richard Blumenthal has launched a separate investigation into Ingenix’s practices.
The American Medical Association, along with several state associations, previously sued United Health for payment fixing. That nine-year-long case was settled last month for $350 million.
At 11 a.m., Aetna traded at $33.28, down 93 cents, or 2.7 percent. Cigna traded at $21.01, off $1.24, or 5.6 percent.
