Insurers Colluded to Underpay Doctors, Now Targeting Children
A Win for Doctors
A federal judge approved a $350 million class action settlement with UnitedHealth Group, awarding an additional $89 million in attorney fees and expenses.
The settlement in The American Medical Association v. United Healthcare Corporation resolves claims that UnitedHealth colluded with others to underpay doctors outside of its network.
Law.com reports that the suit was filed in 2000 by the American Medical Association, along with other medical groups, providers, and patients who were harmed by UnitedHealth’s use of a database to determine payments to out-of-network providers.
In 2009, UnitedHealth agreed to a $50 million settlement and closure of the database after an investigation by New York Attorney General Andrew Cuomo. Two days later, the class action was filed, requiring the end of the database on a national basis.
Critics of health care reform and The Affordable Care Act often point to concern for doctor payment when the bill is fully enacted. It seems insurers were already doing all they could to cut into physician payments.
A Loss for Children
With a key component of The Affordable Care Act coming into play this week, insurers are targeting another group — children. The new law requires insurers to accept applications from sick children — but doesn’t require them to sell policies to children at all.
An article on Wall Street Journal online reports that Aetna Inc., Cigna Corp., WellPoint Inc., Humana Inc., and UnitedHealth Group Inc’s Golden Rule subsidiary will no longer sell new child-only policies, thereby forcing parents to apply for coverage for their children on their own plans. That’s assuming they have plans for themselves.
This is exactly what insurers said they would not do.
WSJ quotes Nancy Pelosi as saying, “Earlier this year, the companies pledged to cover children with pre-existing conditions — in keeping with the spirit of reform that requires they no longer drop coverage for these children. Now, some companies are backtracking on writing new policies, potentially leaving many children without the health insurance they desperately need.”
“This offensive behavior by the insurance companies is yet another reminder of why the new law is so important and why the Republican call for repeal is so misguided. For too many years, it’s been the insurance companies against us, and they win. With the new consumer protections, we can start winning for a change – and get the health care we pay for and need.
If the insurance companies are so willing to turn their backs on sick children now, who will they abandon next?”
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