Payers News Briefs
New York AG probe into top insurers goes on
A six-month government investigation has led to charges that United HealthGroup subsidiary Ingenix operates a defective and manipulated database that is used by most major health insurance companies to set reimbursement rates. New York Attorney General Andrew M. Cuomo revealed the results of his investigation last month and announced he is conducting an industry-wide investigation into a scheme by health insurers to defraud consumers by manipulating reimbursement rates. At the center of the alleged scheme is Ingenix, the largest provider of healthcare billing information in the country, which serves as a conduit for rigged data to the largest insurers, Cuomo charged.
Kentucky plan goes to electronic charge capture
The Kentucky Medical Services Foundation in Lexington, Ky., is moving to an electronic charge capture system for its clinician base of more than 600 providers. KMSF is the faculty practice plan for the University of Kentucky Medical Center and the College of Medicine. The foundation has selected technology developed by Boston-based MedAptus. MedAptus’ Professional Charge Capture supports compliant and streamlined coding at the point-of-care. The system is integrated with numerous scheduling, billing and registration EMR systems.
CareFirst helps providers with EHR projects
CareFirst BlueCross BlueShield has invested more than $1.5 million in two electronic health records projects in Maryland. It has pledged $967,000 to plan and implement an electronic health record system at Community Health Integrated Partnership in Glen Burnie, a group of seven community health centers. The company said it would also contribute $550,000 to an $800,000 EMR project at LifeBridge Health.
Cigna extends contract with Healthways
Cigna HealthCare signed a three-year contract extension with Healthways Inc. to provide care management and wellness programs through February 2013. Nashville, Tenn.-based Healthways provides services including call centers and nurse educators that help Cigna members better manage their illnesses, avoid unnecessary hospitalization, and stop or slow the progression of their disease. Financial terms of the deal were not disclosed. The programs serve about 1.2 million members.