N.Y. AG settles with 8 health insurers

Bryan Cohen Jan. 20, 2012, 12:51pm


NEW YORK (Legal Newsline) - New York Attorney General Eric Schneiderman has announced settlements with eight major health insurance companies for allegedly failing to publish accurate provider directories.

The settling companies include Vytra Health Plans, United HealthCare Insurance Company of New York, Oxford Health Plans of New York, United HealthCare of New York Inc., HIP Insurance Company of New York, Health Insurance Plan of Greater New York, Empire HealthChoice Assurance Inc. and Empire HealthChoice HMO Inc. The settlements require the companies to ensure the accuracy of their provider directories by removing providers who no longer participate and correcting errors in listings for providers who are participating.

In addition, Thursday's settlements require that insurers enact new business practices for updating their online provider directories in a timely manner in the future. They must also pay restitution to consumers who paid more than they should have by going to providers insurers listed as in-network in error.

"Consumers are entitled to accurate information from their health care insurers, especially for something as basic as whether or not their doctor is in their network," Schneiderman said. "Inaccurate directories lead to delays in care and additional costs to the consumer, particularly when that consumer winds up seeing a doctor who is not actually a provider in the plan and pays out of pocket. These settlements fix inaccurate provider directories and their significant negative impact on consumers."

Schneiderman's Health Care Bureau alleged that the companies had inaccurate directories that wasted consumers' time and delayed access to medical care after discovering through the phone or via an appointment that the physician was no longer participating in the plan. Consumers also allegedly had delays in medical care when participating doctors were listed with incorrect contact information or when they were referred to providers who no longer participated.

Under the terms of the settlement, the companies must collectively pay $60,000 to cover court costs, log complaints related to the accuracy of participating provider listings and document how the complaints were resolved individually, engage an independent entity to audit settlement compliance, prepare and file reports with Schneiderman's office on the status of the continual correction of their directors, refund consumers for amounts paid for services given by non-participating providers who had been listed in the online provider director at the time they received services, and update their provider directories online within 30 days of receiving verified provider information in the future and track changes.

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