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UnitedHealthcare just agreeded to pay a paltry $350 million to settle a charges that the multi-billion dollar concern defrauded its customers via a corrupt database subsidiary. Reuters reports: UnitedHealth Group Inc agreed on Thursday to pay $350 million to resolve class action lawsuits over reimbursing patients for out-of-network medical services. The settlement comes two days after UnitedHealth struck an agreement with the New York state attorney general following a probe into the independence of the company database used to set reimbursement rates for patients' medical bills. Aetna Inc (AET.N), which will pay $20 million to help establish an independent database used for calculating rates. Aetna's payment adds to the $50 million UnitedHealth agreed to pay earlier this week to fund the database. UnitedHealth is also shutting its Ingenix medical billing information service, which has been at the center of the probe. UnitedHealth's $350 million settlement resolves litigation filed on behalf of the American Medical Association, health plan members, healthcare providers and state medical societies ... Other health insurers also face similar class action lawsuits. "This scam cost consumers hundreds of millions of dollars," Cuomo said during a news conference on Thursday. ... UnitedHealth, the largest U.S. health insurer by market value, said it would pay for this settlement with cash on hand, with the accrual included in its results for the fourth quarter of 2008. A probe by Cuomo, announced last February, found that UnitedHealth's Ingenix unit operates a "defective and manipulative" database that most major health insurers use to set reimbursement rates for out-of-network medical expenses. Insurers often promise to cover up to 80 percent of the so- called "usual and customary" rate of an out-of-network expense, with consumers responsible for paying the balance. The Ingenix database would skew these rates downward [read: LIE, DEFRAUD] compared with the actual market rate, shortchanging [stealing from] consumers, Cuomo said. "By using a flawed database to determine reimbursement rates for out-of-network care, insurers have increased profits at the expense of patients and physicians," AMA President Nancy Nielsen said in a statement. Cuomo has also said his office would approach other health insurers about using the new database and contributing money to fund it. UnitedHealth shares were down 13 cents at $23.95 at midday on the New York Stock Exchange. Aetna shares were down $1.03 cents, or 4 percent, at $25.08.
How many sick people did this organized crime ring steal from? How many of these victims of corporate fraud were forced to "cut their losses" by going "in network"? What was the impact on the care received? How many more people may have lived had they not been limited in treatment by the insurers' criminal scheme? UnitedHealth, Aetna and the rest of the private health insurance industry are guilty of murdering their customers via spreadsheet with "medical loss" reduction schemes and acts of criminal fraud like the scam mentioned above. Corporate crimes are like roaches. For everyone you see in the papers twenty remain uncovered. Corrupt corporations such as UnitedHealth and Aetna should be held to account not in the civil courts but where they rightfully belong -- the criminal courts. In a more just society the CEOs and top directors of these companies would be charged with mass murder. The guilt at the heart of the database scheme is just the latest exclamation point on the moral case against the private health insurers. A corporate death sentence is in order for the entire sector - it must be nationalized as punishment and remedy. This is easily accomplished by the expansion of the successful and efficient Medicare program to all who reside in America. Medicare for All in 2009! - Christopher Blair
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