Issue:  2006-05-26

Department Announces Prompt Pay Violation Fines

♦ New York

NEW YORK, N.Y., May 26 – Insurance Department Superintendent Howard Mills has announced the latest fines, totaling $266,600, against 21 health insurers and health maintenance organizations (HMOs) for violations of New Yorks Prompt Pay Law. The violations and subsequent fines stemmed from complaint files that were closed by the Insurance Department between October 1, 2005 and March 31.

New Yorks Prompt Pay Law requires health insurers and HMOs to pay undisputed health insurance claims within 45 days of receipt, ensuring timely payment, Mills explained. Since Governor George E. Pataki signed this measure into law in 1997, the Insurance Department has levied nearly $6.5 million in fines against health insurers and HMOs for Prompt Pay Law violations. New Yorks Prompt Pay Law has been extremely effective in ensuring that consumers and health care providers are paid in a timely fashion, and remains an excellent deterrent against entities slow to pay undisputed claims, Mills stated.

The fines announced are:

Aetna Health, Inc. " $37,900;

Affinity Health Plan " $4,800;

Americhoice " $24,700;

CIGNA " $4,200;

Empire " $13,900;

Excellus " $1,900;

Fidelis " $1,200;

GHI " $5,900;

GHI HMO " $2,000;

Guardian " $3,100;

Community Blue " $2,500;

HealthNow " $1,600;

HIP " $42,000;

HealthNet " $27,300;

HealthPlus, Inc. " $2,000;

Horizon Healthcare " $1,900;

MDNY " $1,600;

Oxford " $16,900;

St. Barnabus (Partners in Health) " $1,300;

United Healthcare " $24,400;

Vytra " $45,500.

hamond-ad-web.jpg

insurance_ed_ad.gif

ecommerce-solutions.gif