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One of the issues we studied in class last semester was the usually, customary and reasonable (UCR) exclusion. I mentioned that there was litigation pending over this as well as several investigations. Today’s Los Angeles Times reports a significant development today.

Anthem Blue Cross of California parent WellPoint Inc. colluded with database firm Ingenix to fix prices in a multistate scheme to underpay doctors for so-called out-of-network medical care, physician organizations contended in a lawsuit filed Wednesday.Ā 

The American Medical Assn., the California Medical Assn. and other state medical organizations said in the suit filed in federal court in Los Angeles that the scheme cost physicians millions of dollars and resulted in patients paying more than they should have.


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