New York State

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(212) 480-5262
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James J. Wrynn    Superintendent of Insurance    25 Beaver Street  New York, N.Y. 10004

ISSUED 8/24/2010FOR IMMEDIATE RELEASE

PROMPT PAY VIOLATIONS LEAD TO $716,800 IN FINES

The New York State Insurance Department today announced that 20 health insurers and health maintenance organizations (HMOs) have been fined $716,800 for violating New York's Prompt Pay Law. The violations and subsequent fines stemmed from complaint files that were closed by the Insurance Department between Oct.1, 2008 and Sept. 30, 2009.

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. By agreeing to pay the fines imposed by the Insurance Department, the companies are acknowledging that they failed to pay certain claims within the state-mandated timeframe.

"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.

Insurers and HMOs have paid the state $9.1 million in prompt pay fines since 1998 when the law became effective.

The fines announced today included:

Company
Total Fine
Aetna
$25,100
Affinity
$154,000
Amerigroup
$43,500
CIGNA
$57,750
Empire
$31,500
Excellus
$8,000
Fidelis
$7,200
GHI
$68,500
GHI HMO
$2,400
Guardian
$2,600
HealthFirst
$24,900
HealthNet
$13,600
HealthPlus
$9,600
HIP
$54,500
MetroPlus
$3,300
Neighborhood Health
$1,000
NY-Presbyterian
$9,600
Oxford
$31,100
United Healthcare
$159,650
Wellcare
$9,000
Total
$716,800
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