Health Care Fraud and Mismanagement
Attorneys general are known to bear unique responsibilities in the area of consumer protection. This includes the power to investigate and regulate health care institutions, including insurance companies and hospitals, in order to prevent fraudulent or unfair practices and promote the best interest of the consumer.
Hospital Uninsured Patient Discount Act - Illinois
The Hospital Uninsured Patient Discount Act, drafted by Attorney General Lisa Madigan and passed by the Illinois legislature, provides for hospital charge discounts and caps on hospital bills for eligible uninsured patients.
Madigan Legislation to Reduce Hospital Charges for Uninsured
Illinois Hospital Association's memorandum on the new legislation
Full text of the Hospital Uninsured Patient Discount Act
Blue Cross Blue Shield of Michigan
In 2008, Attorney General Mike Cox of Michigan opposed efforts by Blue Cross Blue Shield of Michigan (BCBSM) to pass legislation that he claims would "guarantee rate hikes on seniors and the seriously ill, eliminate financial oversight by the governor and attorney general, and allow BCBSM to purchase for-profit companies." Since then, Cox has vocally advocated for various reforms of BCBSM in order to maintain its status as insurer of last resort.
Cox also filed an unsuccessful lawsuit against BCBSM to force the insurer to apply funds that had been used to purchase a California worker's compensation fund instead toward reducing insurance costs.
AG Cox Sues Blue Cross - Fact Sheet
Cox Calls on Legislature to Stop Blue Cross Bills
Blue Cross admits $210 million error
Cox offers Legislature Ten Ideas for Health Care Reform
Blue Cross Blue Shield Wins Lawsuit, Attorney General Deciding Whether to Appeal
Cox's letter to state legislators on health care reform at the start of the 2009-10 legislative session
Fairness in coverage
Attorney General Richard Blumenthal of Connecticut Calls for Gender Equity in Health Care Coverage
Health Care Reimbursement Litigation - New York
As part of New York Attorney General Andrew Cuomo's investigation of insurers' out-of-network reimbursement policy, health insurance company Aetna settled with Cuomo for $5 million to reimburse college students who had been overcharged due to the use of outdated out-of-network coverage information. Cuomo had previously brought a similar suit against UnitedHealth and its subsidiary, Ingenix, for a similar case in which the insurer under-reimbursed members by using faulty out-of-network coverage data provided by Ingenix.
In February 2009, Cuomo announced plans to file suit against Univera Healthcare and its parent company, Excellus Health Plan, for underreimbursing patients due to flawed data from the Ingenix system. Cuomo also reached a settlement over reimbursements with Cigna Corp., which agreed to discontinue use of the Ingenix database.
Aetna, AG Reach $5M Settlement
Attorney General Cuomo Secures Agreement With Aetna to Reimburse Health Insurance Claims for Over 73,000 Students at Over 200 Colleges Nationwide
Aetna - Assurance of Discontinuance
Cuomo announces industry-wide investigation into health insurers' fraudulent reimbursement scheme (United)
United - Notice of Litigation
Cigna - Assurance of Discontinuance
Attorney General Cuomo secures agreement with Cigna to join historic health insurance reform efforts - announces intent to sue Excellus for defrauding patients across upstate NY
Albany Business Review, AG Targets Univera in Reimbursement Probe
Univera/Excellus - Proposal of Litigation
Allina Hospitals and Clinics - Minnesota
Minnesota Attorney General Lori Swanson filed suit in early 2009 against Allina Hospitals and Clinics for charging up to 18 percent interest on medical bills. According to Swanson, state law limits interest on medical debt at 8 percent.
Allina has agreed to reimburse any patients who were charged over 8 percent interest over the last two years, a settlement expected to be worth over $1 million.
Minnesota sues over Allina's 18% interest rate
Statement from Attorney General Swanson on lawsuit
Allina Health System agrees to patient refunds
Statement from Attorney General Swanson on settlement