New York fines 20 insurers $716,800 for ‘prompt pay’ violations

New York insurance regulators clamped down on 20 health insurers and HMOs operating in the state by fining them a total of $716,800 for failing to promptly pay claims.

The New York State Insurance Department said the violations of New York’s Prompt Pay Law stemmed from complaint files that were closed by the agency 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 NYSID, the companies acknowledged that they failed to pay certain claims within the state-mandated timeframe, officials noted in a statement.

“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,” New York Insurance Superintendent James J. Wrynn said in the statement.

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

In the latest action, companies and fines included:

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

UnitedHealthcare, $159,650

Wellcare, $9,000

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