Ingenix at Root of another Reimbursement Fraud Case

On February 17, 2009, WellPoint Inc. agreed to stop using the Ingenix database of reimbursement rates that New York Attorney General Andrew Cuomo called “defective and manipulated.”

WellPoint acknowledged that the Ingenix database contained a conflict of interest, which led them to pay $10 million to settle a New York probe into how the Indianapolis-based health insurer reimbursed customers for out-of-network services. The $10 million will be used by Cuomo to create a not-for-profit database that will replace Ingenix and be accessible for both insurers and their customers.

WellPoint Inc. is the fourth large insurance company to discontinue use of the Ingenix database due to the Cuomo fraud probe. UnitedHealth, Cigna and Aetna are the other three. CCH Chicago Bureau, Feb. 18, 2009.