MVP Health Care is First Upstate New York Based Health Insurer to Agree with Attorney General Andrew Cuomo on Out-Of-Network Provider Payment Reform

SCHENECTADY, N.Y., Feb. 4 /PRNewswire/ — Attorney General Andrew Cuomo and MVP Health Care today announced an agreement that supports his plan to establish a new not-for-profit organization to gather, maintain, and analyze provider reimbursement data for use by health insurers who choose to pay out of network providers using usual, customary and reasonable fees.

The agreement with Attorney General Cuomo is the first involving an upstate New York based health insurer. The company issued the following statement by Denise Gonick, MVP Health Care executive vice president and chief legal officer at an Albany news conference with the Attorney General today:

“As a not-for-profit health insurer, serving more than 700,000 members, we appreciate and support your leadership in guaranteeing that New Yorker’s hard-earned health care dollars are spent on providing the best care possible.

“MVP Health Care strives to make all of our decisions clear and easy for consumers and providers to understand.

“Like many other health insurers, MVP used Ingenix data to establish usual, customary and reasonable (UCR) reimbursements for out of network providers because Ingenix was the industry standard. However, unlike many other insurers, MVP only used this database for a very small number of claims – less than 1 percent of the 12 million claims we process annually. Still, we recognize the Attorney General’s concern about conflicts of interest inherent in the Ingenix database and appreciate his providing our industry with an independent process that is transparent and helps consumers make more informed health care purchasing decisions.

“We agree with the Attorney General that this will help consumers better understand the actual cost of care. We welcome the opportunity to be the first upstate New York based health insurer to introduce this reform to our members. We believe that consumers and providers will be well-served by the joint effort that we are announcing today.”

About MVP Health Care

Founded in 1983 MVP Health Care is a regional, not-for-profit health insurer based in Schenectady, N.Y. Through its operating subsidiaries, it provides fully-insured and self-funded employer health benefits plans, dental insurance and ancillary products, such as flexible spending accounts to 700,000 subscribers in New York state, Vermont, and New Hampshire. For more information visit: www.mvphealthcare.com/press.

SOURCE MVP Health Care