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Prompt Pay Violations Lead To $716,800 In Fines

Originally Posted: August 24, 2010


Albany - The New York State Insurance Department 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 October 1, 2008 and September 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 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
 • United Healthcare - $159,650
 • Wellcare - $9,000




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