The announcement last month that New York Attorney General Andrew M. Cuomo was getting ready to sue UnitedHealth Group and its subsidiaries over “fraudulent, deceptive, and illegal business practices” drew a flurry of media and other attention.

At issue was the system the insurer has been using to set reimbursement rates for out-of-network services. The AG’s office alleges that the system incorporates intentionally flawed data, thereby yielding “unduly low reimbursements to members.” UnitedHealth Group, which has promised to cooperate fully with the AG, has defended its rate-setting methodology, adding that it’s “committed to fair and appropriate payment for physicians, the state’s other healthcare providers, and consumers.” continues…

No Comments »

From Medical Economics magazine, more on organized medicine ...

A new lobbying group has formed for physicians in New Jersey who are sick of the status quo. Calling itself NJ Physicians, the group seeks to push to lower medical malpractice premiums and improve managed care.

“The impetus for our group is that the Medical Society (of New Jersey) has over the years not been as effective as most physicians want,” said Ron White, chief of surgery at Bergen Regional Medical Center in Paramus and president of the new group.

New doctors group to form [Via NJ Star Ledger]

Link or the group’s website

No Comments »

From Medical Economics magazine, more on organized medicine ...