21 HEALTH INSURERS, HMOs FINED FOR PROMPT PAY VIOLATIONS

Superintendent of Insurance Howard Mills today announced that the New York State Insurance Department has levied fines totaling $310,300 against 21 health insurers and health maintenance organizations (HMOs) for violations of New York’s Prompt Pay Law. The violations and subsequent fines stemmed from complaint files that were closed by the Insurance Department between Oct.1, 2005 and March 31, 2006. New York’s Prompt Pay Law requires health insurers and HMOs to pay undisputed health insurance claims within 45 days of receipt, ensuring timely payment. Since Governor Pataki signed this measure into law in 1997, the Insurance Department has levied nearly $6.8 million in fines against health insurers and HMOs for Prompt Pay Law violations. By agreeing to pay the fines imposed by the Insurance Department, the companies are acknowledging that they failed to pay certain claims within the state-mandated timeframe. Moreover, health insurers and HMOs are also required to pay interest on undisputed claims in which payments were delayed. "New York’s Prompt Pay Law has been extremely effective in ensuring that consumers and healthcare providers are paid in a timely fashion and remains an excellent deterrent against entities slow to pay undisputed claims," Superintendent Mills stated. The fines announced today, by company, are: Health Ins. -- Fine Aetna -- $8,400.00 Affinity -- $5,000.00 Americhoice -- $30,100.00 Careplus -- $1,900.00 Centercare -- $3,400.00 CIGNA -- $2,100.00 Empire -- $5,000.00 Excellus -- $3,200.00 Fidelis -- $1,200.00 GHI HMO Select -- $2,300.00 Group Health, Inc. -- $13,800.00 Guardian -- $1,400.00 Health Plus -- $65,300.00 HealthNet -- $58,800.00 HealthNow -- $3,100.00 (includes Community Blue) HIP -- $7,400.00 Horizon -- $1,800.00 MDNY -- $22,900.00 Oxford -- $19,100.00 United Healthcare -- $16,300.00 Vytra -- $37,800.00 Consumers and healthcare providers with prompt pay complaints should call the New York State Insurance Department’s toll-free hotline at 1-800-358-9260.