New Hope for Over-Charged Health Insurance Customers

New System Could Benefit 100M Patients

In the last six months, the New York State Attorney General's office has secured agreements with 12 health insurers -- including Ingenix owner UnitedHealth Group, Aetna, Cigna and WellPoint, Inc. -- to stop using Ingenix. The insurers, instead, will contribute millions toward the creation of a new, independent national database to replace it.

The database is expected to benefit the some 100 million health insurance customers across the country who pay extra premiums for health insurance coverage that includes out-of-network benefits.

The new database will be "a completely unaffiliated third-party system," the A.G.'s office said, and won't be racked by the same conflicts of interest as Ingenix.

The office has collected, thus far, about $94 million through settlements with the insurance companies, including $50 million from UnitedHealth, $20 million from Aetna and $10 million each from Cigna and WellPoint.

Later this summer, the Attorney General's office will name a nonprofit group to run the database. The database should be in operation about six months, Cuomo's office told, after the group is named.

'World-Class' Health Insurance, High Bills

It was complaints by health insurance consumers like Jerome that brought the Ingenix issue to the attention of the New York State Attorney General.

Jerome said she was shocked by the medical bills she began receiving shortly after she began her cancer treatments in 2006. Her then-health insurer, Oxford -- which is owned by UnitedHealth -- was footing tens of thousands of dollars in medical expenses, but by 2007, Jerome was still on the hook for at least $50,000.

Jerome, an English-as-a-second language professor at Columbia University, used a small inheritance from her military-veteran parents to pay some of her medical bills. But she also appealed to various officials, including Cuomo's office, asking them to investigate the issue.

"I realized this wasn't right," she said. "You can't be getting a world-class health insurance and be asked to pay this much."

Cuomo's office and the Senate Commerce Committee have highlighted Jerome's story and stories like hers in their efforts to change the system.

These days, Jerome said, her health insurance company -- she now gets her coverage directly from UnitedHealth -- treats her very well.

"They know who I am now," she said with a chuckle. "I'm infamous in their eyes."

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