State fines 14 plans for violating prompt-pay law

Top fine nearly $52,000

The New York superintendent of insurance has levied fines totaling $115,800 against 14 health insurers and HMOs for violating the state’s Prompt Pay Law. This is the second time this year the state has taken such action. The first round of fines resulted in penalties totaling $72,200.

The state’s department of insurance has received over 28,000 slow-pay complaints from providers since the Prompt Pay Law went into effect in January 1998.

"We are putting all health insurers on notice that they must pay patients and providers on a timely basis," says Neil D. Levin, superintendent of insurance. "We will closely monitor industry compliance with the Prompt Pay Law and continue to impose penalties on those companies that fail to comply."

New York’s Prompt Pay Law requires HMOs and insurers to pay undisputed health insurance claims within 45 days of receipt, ensuring the prompt, fair, and equitable payment of patient and provider claims.

The companies were fined $100 per violation of verified complaints for late payments from Oct. 1, 1998, through Feb. 1, 1999. By agreeing to pay the fines, the plans acknowledged that they failed to pay claims promptly and agreed to make corrections necessary to avoid future late payments.

The late-paying plans and their fines included: Oxford ($51,900), Aetna/US Healthcare ($31,900), Empire Blue Cross Blue Shield ($1,200), Pruden tial Healthcare ($1,900), Unicare ($1,200), Wellcare ($1,200), HIP ($7,100), NYLCare ($2,400), GHI, ($2,200), CIGNA ($2,700), Capital District Physi cians Health Plan ($1,100), Health Now ($1,200), VYTRA ($8,300), and CHP ($1,500).