Practice Management Alert

Payer Updates:

NY Insurance Department Fines Payers For Prompt Pay Violations

The New York State Insurance Department fined 20 payers for not paying providers within the required 45 days on undisputed claims as required by New York's Prompt Pay Law. The violations and subsequent fines -- totaling $716,800 -- resulted from complaints between Oct. 1, 2008 and Sept. 30, 2009. Some of the affected payers include Aetna ($25,100), CIGNA ($57,750), HealthNet ($13,600), United Healthcare ($159,650), and Wellcare ($9,000).

"The Prompt Pay Law has been extremely effective in ensuring that consumers and health care providers are paid in a timely fashion and it remains an excellent deterrent against entities slow to pay undisputed claims," Superintendent James Wrynn said in a statement.

In other news: California insurance regulators gave WellPoint's Anthem Blue Cross the green light to raise rates an average of 14 percent, with some as high as 20 percent. The approval came after WellPoint said there were "inadvertent" errors in an initial filing from earlier this year, which were discovered by an independent actuarial analysis requested by California Insurance Commissioner Steve Poizner.

When Anthem resubmitted the request regulators approved the hikes because at least 70 percent of premiums will go toward payment for medical care. The state Insurance Department said Wednesday the six-month delay saved policyholders $184 million. "These savings were a clear benefit to Blue Cross' policyholders," said Deputy Insurance Commissioner Byron Tucker. Blue Shield of California was also allowed to increase rates at an average of 19 percent.

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