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Aetna to pay $20 million settlement

Hartford Courant, January 16, 2009

Aetna has announced it agreed to pay $20 million to settle New York’s accusations that it and other health insurers use a manipulated system that shortchanges doctors and hospitals on reimbursement for providing out-of-network services. The news comes two days after New York Attorney General Andrew M. Cuomo announced that UnitedHealth agreed to a $50 million settlement of his investigation into the way insurers pay for care when members go outside the managed care networks. UnitedHealth’s Ingenix unit operates the databases that many insurers use to determine what the "reasonable and customary" charge for each out-of-network service should be in each area. Aetna said it will contribute $20 million in installments over five years, at Cuomo’s request, to help establish the new database that is part of New York’s settlement with UnitedHealth.