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AMA Hails Attorney General Cuomo for Launching Project to Replace Tainted Ingenix Database

For immediate release
Oct. 27, 2009

Statement attributable to:
William A. Dolan, MD
AMA Board Member

"The American Medical Association commends Attorney General Andrew Cuomo for the landmark achievements of forcing health insurers to end to a rigged system for setting payments and successfully negotiating a transition to a more transparent system. The cumulative impact of these achievements will bring national reforms that benefit tens of million of Americans who receive care outside their insurer's network of physicians.

"The AMA had been fighting in court for almost a decade against the industry-wide insurer scheme to defraud patients and physicians of proper reimbursement. It was Attorney General Cuomo's intervention that really helped us move beyond the AMA's lawsuit and get to a point where critical reforms could be implemented nationally.

"At the heart of this reform movement was the closure of the insurer-controlled Ingenix database. Use of this flawed database by health insurers across the country corrupted the system for paying out-of-network medical bills, resulting in patients and physicians being cheated of proper reimbursements.

"Patients and physicians have a right to expect fair and accurate payment for services promised to them by health insurers. But a lack of transparency, accuracy and integrity in the Ingenix database allowed insurers to place profits ahead of their promises to patients and physicians. Those of us who have been shortchanged by insurance companies can now look forward to getting the straight deal we always deserved.

"Attorney General Cuomo's vision for replacing the Ingenix database promises to help patients and physicians hold insurers accountable to their obligations by bringing transparency, accuracy and integrity to the system for determining out-of-network reimbursement rates. FAIR Health will have an important role in spearheading national reforms that should give patients and physicians a reimbursement system that is transparent and free from corporate manipulation.

"We are delighted that Syracuse University has been selected to lead the development effort for a new resource to replace the Ingenix database. Syracuse University has exceptional resources and respected experts who have demonstrated a deep understanding of the medical profession's concerns with the Ingenix database. The combined resources of Syracuse University and the upstate research network should result in the rapid creation of a new database that is free of the flaws inherent in the Ingenix database.

"As a New Yorker, I am proud to be here today with the New York Attorney General and thank him personally on behalf of the nation's physicians and the patients we serve for his efforts to implement truly important health insurer reforms. It is my pleasure to offer the AMA's assistance in ensuring his unprecedented solutions are successfully implemented."

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Contact:

Robert J. Mills
AMA Media Relations
Office: (312) 464-5970
E-mail: robert.mills@ama-assn.org