NY Attorney General Issues More Subpoenas to Insurance Companies

New York Attorney General Andrew Cuomo has issued new subpoenas to Aetna Inc., Cigna Corp., UnitedHealth Group Inc. and WellPoint Inc., and other health insurers in a broadening investigation of possible fraud costing consumers hundreds of millions of dollars. Cuomo is also looking to subpoena testimony from the chief executives of those companies, as well as from executives of Empire Blue Cross Blue Shield, Excellus, and the combined Group Health Inc. and HIP Health Plan. Cuomo is seeking all e-mail correspondence involving the companies' CEOs, chief operating officers, chief fiscal officers, presidents and employees supervising claims. He also wants any records that might challenge the accuracy of reimbursements that he feels are too low. Cuomo says he believes the companies used the UnitedHealth Group-owned Ingenix to set rates, which resulted in consumers being reimbursed at unfair and unjustifiably low rates. Low reimbursements mean higher out-of-pocket costs for consumers when they choose or need physicians outside their health plans.

Cuomo believes that insurance companies, which face less competition and record profits after a series of mergers, aren't fulfilling their commitment to pay fair reimbursements. The new subpoenas are part of a case first announced in February. It relies on the state's powerful Martin Act, which provides criminal and civil enforcement powers for publicly traded companies. Cuomo is basing the other subpoenas on state consumer fraud laws. Cuomo is also seeking to compel the testimony of CEOs to determine if the companies knew they were relying on artificially low reimbursement rates for customers and if the companies' investors knew of the practices. The AMCNO has sent this background and information to the Ohio Attorney General asking for his input on this matter.