WASHINGTON — Congressional investigators said Wednesday that two-thirds of the U.S. health insurance industry used a faulty database that overcharged patients for seeing doctors outside their insurance network, costing Americans billions of dollars in inflated medical bills.
The flawed database is operated by Ingenix, a subsidiary of health insurer UnitedHealth Group, which agreed in January to pay $350 million to settle allegations that it deliberately kept rates low to underpay doctors, driving up expenses for patients.
An investigation by Sen. Jay Rockefeller, D-W.Va., shows that nearly 20 regional and national insurers also used Ingenix data. An ongoing probe by New York Attorney General Andrew Cuomo previously focused on the use of Ingenix data by only a handful of top insurers, including Aetna, Wellpoint and Cigna. About a dozen insurers, including UnitedHealth, have already settled with Cuomo.
More than 100 million Americans have plans that let them see doctors who are not part of their insurance network. For more than a decade, insurers submitted data to Ingenix to determine the typical cost for care received outside their networks. But congressional investigators say companies would deliberately skew data to underestimate the costs of medical services, leaving patients to pay more in out-of-pocket expenses.
The report arrives as President Barack Obama and Democrats in Congress step up calls for a public health care option, “to keep health insurance companies honest.”
A bipartisan group of governors told Obama on Wednesday that they share his urgent desire to restructure the nation’s health care system but warned that any changes should not place more burdens on already strained state budgets or eliminate innovative programs they already have in place.
With many state budgets burdened by ballooning Medicare and Medicaid costs, the five governors who met with Obama at the White House agreed that changes are needed to expand health care coverage and contain its growing costs.
“If we’re going to add more population onto the Medicaid rolls, there has to be a way to pay for that,” said Michigan Gov. Jennifer Granholm, a Democrat, adding that it is a point that Obama supported.
The Washington Post contributed to this report.
