AG Cuomo Sets Healthcare Reimbursement Reform

By Dave Lucas

Syracuse, NY – A groundbreaking health insurance reform announcement with national implications was delivered in Central new York this morning by the New York State Attorney General. Capital District Bureau Chief Dave Lucas reports.

In his remarks at Syracuse University, Andrew Cuomo stressed that health care is the overall cause of concern for most Americans. He says his office fields 60 thousand complaints a year the overwhelming majority of those involve health care. Three years ago the A-G launched an investigation of the consumer re-imbursement system.

The probe found that Ingenix got its data from the same insurance companies it was sending data back to. Calling Ingenix a "black box," Cuomo said it created a conflict of interest because insurers were both providing and using the same data in calculating reimbursement rates.

Cuomo pointed out that one of every three Americans go out-of-network for health care services. His solution includes a new re-imbursement system, called "Fair Health" --- $100 million in settlement money from health insurance companies will fund the new effort.

Research for the new health care database will be centered at Syracuse University's Maxwell School and its School of Information Studies: other members of the upstate research network include UBuffalo, Cornell University, University of Rochester, and SUNY Upstate Medical University.

The organization will also maintain a website where consumers and doctors can check reimbursement rates. Cuomo expects to have the new system up and running within one year.