ALBANY, N.Y., August 16 – Attorney General Andrew M. Cuomo has issued warnings to Aetna and Cigna Healthcare, which includes United Healthcare, stating that their physician ranking programs, as currently designed, are likely to confuse or even deceive consumers. In letters to the insurers, Cuomo expressed concern about the design of the programs and requested a full justification for them.

Transparency and accurate information are essential when consumers make health care decisions, said Cuomo. We will ensure that insurance companies are not obscuring important facts at the consumers expense.

Health insurance companies create physician ranking programs to recommend certain primary care physicians and specialists to consumers. In his letter to Aetna and Cigna Healthcare, Cuomo states that:

The rankings are based on claims data, which is well-known to carry significant risks of error when used to rank individual physicians;

The insurers do not disclose the accuracy rate of their rankings;

Insurers have a profit motive to recommend doctors who cost less; not necessarily those who are most qualified.

The letter also describes how inaccurate physician ranking programs may cause financial harm to consumers. Some employers steer employees to the doctors preferred by the insurer by lowering copayments or deductibles. Consequently, employees who choose not to go to the preferred doctors could pay more.