New National Health Care Claims Database to Replace Flawed System

New York state Attorney General Andrew Cuomo selected Syracuse University to lead a research effort that will create a new national health care claims database. The new entity will create an alternative to the one owned by Ingenix, which was the subject of an investigation and fines by his office.

Cuomo has said that the flawed Ingenix database was improperly used by health insurers across the country to pay low out-of-network medical claims. Cuomo said he would use the fines collected—about $100 million—to create an alternate database.

On Tuesday, October 27, he announced the selection of Syracuse to lead the development. The initiative, called FAIR Health, will be based at Syracuse and coupled with an upstate research network that will create a more transparent reimbursement database.

Ingenix is owned by insurer UnitedHealthcare. The new upstate network will involve Cornell University and the State University College at Buffalo.

The American Medical Association was quick to hail the announcement.

“Syracuse University has exceptional resources and respected experts who have demonstrated a deep understanding of the medical profession’s concerns with the Ingenix database,” the AMA said in a statement. “The combined resources of Syracuse University and the upstate research network should result in the rapid creation of a new database that is free of the flaws inherent in the Ingenix database.”

In June, Cuomo finalized his investigation by announcing that Ingenix ended its relationship with 12 health insurers, including the three largest insurers in the nation, along with the largest national and regional insurers operating in New York state.

Filed by Barbara Benson of Crain’s New York Business, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.

Stay informed and connected. Get human resources news and HR features via Workforce Management’s Twitter feed or RSS feeds for mobile devices and news readers.