NYS Medical Society Initiated Lawsuit against United that Resulted in AG Cuomo's "Greatest Achievement"

• by Medical Society of the State of New York

WESTBURY, NY (01/13/2009)(readMedia)-- Michael H. Rosenberg, MD, President of the Medical Society of the State of New York (MSSNY), said that "the Medical Society of the State of New York is proud to note that it was one of three physician organizations that initiated a lawsuit that resulted in NYS attorney general Andrew Cuomo announcing an agreement with UnitedHealth Group." At the press conference today, Mr. Cuomo identified the agreement as "the greatest achievement of his public service career."

The agreement states that the UnitedHealth Group will finance a replacement for its flawed Ingenix system that determined out-of-network physician fees. Mr. Cuomo claims it as his greatest victory because over 110 million people nationwide will benefit from the new system.

As one of the keynote speakers at the press conference held in Manhattan's St. Vincent's Hospital auditorium, Dr. Rosenberg made the following comments.

"The Medical Society of the State of New York thanks Attorney General Andrew Cuomo for negotiating an agreement with the United Health Group and its subsidiaries - to finally end the abusive use of the Ingenix database to set rates for out-of-network medical payments. Today's announcement by Attorney General Cuomo brings us one 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.

This is a major advance in the Medical Society's mission to make absolutely transparent the way that managed care insurance companies do business. No longer can UnitedHealth Group make payments to out-of-network physicians based on data generated by one of their own subsidiary organizations and presented to the public as being accurate.

The end beneficiaries of this agreement are - first and foremost - patients and then physicians. Patients will benefit because they are one step closer to having an honest accounting for how their health care dollars are being spent. When a patient chooses 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 critical worries about getting better, they shouldn't have to worry about paying for what they thought they had already paid for.

At a time of national economic crisis, the most efficient use of the consumer's health care dollar is a national priority. This settlement signals to the patient and the physician community that even a juggernaut corporation with an $81 billion revenue stream in 2008 must deal fairly with the lives of the millions of individuals for whom they contract to provide health care coverage. And dealing fairly means assuring the patients that tthey will be fairly reimbursed and that he physicians who care for them will be fairly paid for the services they provide.

We thank Attorney General 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 investigation, and we are pleased that United has agreed to help replace the flawed system.

Our medical associations are continuing our pending suit against United on behalf of patients and physicians for the past injustices, and we look forward to that case being resolved in a manner that will recognize United's responsibility to make just compensation for its prior use of the Ingenix database."