Business

Maryland insurance commissioner orders United to pay $1.5 million

NEWS IN BRIEF — Posted June 8, 2009

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

UnitedHealthcare has agreed to reimburse hospitals and radiologists in Maryland $930,000 and to pay $633,000 in fines as penalty for what the Maryland Insurance Administration called noncompliant utilization review policies that placed too heavy a burden on doctors and hospitals.

According to the agreement, an investigation prompted by complaints showed United had not met state requirements for two utilization review programs. The programs are designed to alert the plan when members received elective hospital or radiological care.

According to the agreement, a self-audit by United revealed inappropriate denials of $756,130 in charges in 85 cases to hospitals and $172,599 in 227 cases to radiology groups.

The company did not admit wrongdoing or liability.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2009/06/08/bibf0608.htm.

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn