AMCNO meets with Ohio Attorney General to Discuss New York State Insurance Agreements

As noted in recent AMCNO publications, the New York State Attorney General Andrew Cuomo (D) has signed onto agreements with all of the health insurance plans operating in New York state, which will require the plans to provide its members with more information on how it ranks physicians. This action on the part of the NY AG was prompted when in August 2007, the New York AG warned Aetna and CIGNA that their physician ranking programs likely would confuse or mislead members because of problems with the information used to rank physicians. At the same time, the New York AG had also asked UnitedHealth Group to cancel their launch of a similar program or face possible legal action.

Under the agreements, the plans will divide their preferred physician list into three lists -- one that ranks by cost, one that ranks by quality and one that uses a combination of both measures. The agreements also require that the plans report to the attorney general every six months and use an outside monitor.

Although state law in New York differs from law in Ohio, the AMCNO asked for the Ohio AG’s input on these agreements – in particular on the plan to provide reports to the NY AG every six months and the use of an outside monitor to assure compliance of the plans.

During our meeting with Ohio Attorney General Marc Dann the AMCNO voiced our concern that doctor ranking programs can be confusing and have the potential to steer patients to the least expensive healthcare providers, rather than being based on quality. The Ohio AG stated that he would like to discuss this matter further with the Ohio Department of Insurance in an effort to explore whether or not Ohio would be able to incorporate similar consent agreements with health plans in this state, inclusive of plan oversight to assure compliance and/or if this matter merits the introduction of legislation to achieve these goal. 

The Ohio AG also mentioned his current initiative regarding hospital charity care. The AG plans to set up a work group to address the issue of hospital charity care and he believes that there will be a need for physician involvement in the discussions. The AMCNO plans to follow up with the AG on both the health plan and charitable care issue and remain involved in these discussions.