WellPoint to Pay $10 Million to Settle an Investigation

WellPoint Inc. agreed to pay $10 million to settle an investigation by New York Attorney General Andrew Cumo into questionable insurance reimbursements in the state.

WellPoint is the parent company to Anthem Blue Cross and Blue Shield in Wisconsin and one of the largest health insurers in the state.

In the past 6 months, WellPoint has been working with the Centers for Medicare and Medicaid Services in order to resolve issues identified as a result of the company's internal compliance audits and findings from a recent CMS audit.

In January, Cuomo reached a deal with United Healthcare, under which the database will close. United Healthcare also pledged to pay $50 million to a nonprofit that will establish a new, independent database to help determine out-of-network rates. The measure was followed by the attorney general’s decision to struck deals with other large insurers, including Aetna, Cigna, and MVP Health Care. Under the agreement, they decided to cease using the Ingenix data and contribute to the new database.

“WellPoint is committed to appropriately processing claims and fairly reimbursing health-care providers,” WellPoint said in a statement.

On a national level, WellPoint covers more than 35 million people. WellPoint has about 472,000 Medicare Advantage members and 1.9 million Medicare Part D members, as well as 836,000 members who get insurance to supplement their government Medicare plans.




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