Health Insurers, HMOs fined for prompt pay violations in New York

Twenty health insurers and health maintenance organizations (HMOs) have been fined a total of $716,800 by the New York State Insurance Department for not repaying healthcare providers in a timely manner. New York's Prompt Pay Law requires health insurers and HMOs to pay undisputed health insurance claims within 45 days.

The violations and subsequent fines stemmed from complaint files that were closed by the Insurance Department between Oct. 1, 2008 and Sept. 30, 2009. By agreeing to pay the fines, the health plans are acknowledging that they failed to pay certain claims within the state-mandated timeframe, said the department.

"The Prompt Pay Law has been extremely effective in ensuring that consumers and health care providers are paid in a timely fashion and it remains an excellent deterrent against entities slow to pay undisputed claims," Superintendent James Wrynn said in a statement.

The fines include: Aetna, $25,100; Affinity, $154,000; Amerigroup; $43,500; CIGNA, $57,750; Guardian, $2,600; HealthNet, $13,600; United Healthcare, $159,650 and Wellcare, $9,000; among others.

Health plans have paid New York $9.1 million in prompt pay fines since the law was established in 1998.

For more:
- read the press release

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