22 HEALTH INSURERS, HMOs FINED FOR PROMPT PAY VIOLATIONS
Superintendent of Insurance Howard Mills today announced that the New York State Insurance Department has levied its latest round of fines against health insurers and health maintenance organizations (HMOs) for violating New York’s Prompt Pay Law. In all, 22 companies were fined a total of $178,600 for failing to pay undisputed claims within a reasonable timeframe. The fines are for complaint files that were closed by the Insurance Department between Oct. 1, 2004 and March 31, 2005.
New York’s Prompt Pay Law requires health insurers and HMOs to pay undisputed health insurance claims within 45 days of receipt, ensuring timely payment. Since 1998, the Insurance Department has levied nearly $6.2 million in fines against health insurers and HMOs for Prompt Pay Law violations. Health insurers and HMOs, in accordance with the statute, are also required to pay healthcare providers interest on undisputed claims in which payments are delayed.
"New York’s Prompt Pay Law has been extremely effective in ensuring that consumers and medical providers are paid in a timely fashion while also reducing the number of prompt pay complaints to the Insurance Department. More consumers are seeing their health insurance claims paid on time as a result of this important law," Superintendent Mills stated.
The fines announced today, by company, are:
| Health Insurer/HMO | Fine |
| Aetna Health Inc. | $ 9,300 |
| Affinity Health Plan | 11,100 |
| Americhoice | 12,700 |
| Centercare, Inc. | 2,600 |
| CIGNA | 4,600 |
| Community Blue | 3,600 |
| Empire | 12,900 |
| Excellus | 2,000 |
| Fidelis | 2,700 |
| GHI | 8,200 |
| GHI HMO | 1,400 |
| Guardian Life Insurance Co. | 2,700 |
| HealthNow | 1,100 |
| HIP | 14,600 |
| HealthNet | 13,500 |
| HealthPlus, Inc. | 7,900 |
| Horizon Healthcare | 2,200 |
| MDNY | 2,400 |
| MVP | 1,000 |
| Oxford | 25,100 |
| United Healthcare | 26,100 |
| Vytra | 10,900 |
| Total | $178,600 |
Consumers and healthcare providers with prompt pay complaints should call the New York State Insurance Department’s toll-free hotline at 1-800-358-9260.
