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Regulatory Oversight In Health Care

Law360 (February 27, 2009, 12:00 AM EST) -- Given the results of New York State Attorney General Andrew Cuomo’s investigation into the health insurance industry and the near simultaneous settlement of a class action, the insurance industry — as well as providers — must be asking, what is next?

Cuomo had been investigating the entity known as Ingenix, a group of databases used by various insurers to determine “usual and customary” rates for out-of-network health care providers. Such rates are used to calculate reimbursements to providers.

As a subsidiary of UnitedHealth itself, Ingenix was...
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