Fairness of MVP Ingenix Agreement Makes Quality Healthcare More Attainable to New Yorkers

WESTBURY, NY (02/04/2009)(readMedia)-- On behalf of the Medical Society of the State of New York (MSSNY), I have the great honor and privilege to once again stand next to Attorney General Andrew Cuomo to thank him for negotiating yet another agreement to end the abusive use of the Ingenix database to set rates for out-of-network medical payments. Today's announcement - that MVP Health Care, Inc. has agreed to sign - brings us another big step closer to achieving a major goal that the Medical Society of the State of New York and the American Medical Association have been working on since 2000.

I would also like to thank MVP for agreeing to contribute $535,000 for the establishment of a replacement database that MVP and other insurers will use to determine fair out-of network physician payments. Patients will also be able to find out what usual, customary and reasonable (UCR) medical fees really are in their area.

This agreement with MVP is particularly noteworthy because it will help to reduce the cost of out-of-network medical care for patients in this area, which has been impacted by the economic downturn. Efficient use of the healthcare dollar is particularly important to these New Yorkers today.

The end beneficiaries of this agreement are first and foremost patients and then physicians. When patients choose to pay an additional premium for out-of-network benefits, they are entitled to have that care paid for in a fair and open manner, without worrying about additional out-of-pocket expenses. In addition to their real worries about getting better, they should not have to worry about paying for what they believed they had already paid for. Physicians will benefit because they will be a step closer to a system of honest reimbursement and transparent dealings with MVP.

This is a major advance in the Medical Society's mission to ensure transparency in the way that managed care insurance companies do business. Under the Ingenix schematic, fees were often not accurate as claimed. The ones calculated from the new database will be developed and maintained by an institution that is totally independent from the insurance industry.

We thank Mr. Cuomo for again coming to the assistance of our patients and our physicians. The Medical Society of the State of New York is pleased to have played a role in the Attorney General's investigation, and we are pleased that MVP has agreed to help replace the flawed system.

We thank Attorney General Cuomo for inviting us to share in the announcement of this momentous victory for New York, and we thank him for all the diligent investigative work he and his staff have done to improve the delivery of quality healthcare throughout the state.