Letters: Kudos to New York
January 20, 2015
Thanks to New York for responding quickly to Cigna's star rating system of dentists based on fees charged. Upon learning about this program last fall, the New York State Dental Association immediately introduced legislation to make these price comparisons illegal and also took the issue to the New York State Attorney General. As a result, Cigna withdrew its star rating system and will not use it in New York. Following more recent discussions with the ADA Council on Dental Benefit Programs, Cigna is "postponing implementation" for the rest of the United States.
A few years ago, United Healthcare and its subsidiary Ingenix introduced code modifiers to calculate and create an artificially low UCR for patients of out-of-network dentists. Patients were reimbursed 80 percent of this ridiculously low rate and had to absorb the balance of the dentists' charges, which often drove them to network providers. NYSDA and a coalition of New York health care providers responded quickly and took the issue to the state attorney general who sued United Healthcare, Ingenix and other subsidiaries. The attorney general deemed those actions fraudulent and they were ordered to cease and desist.
Thanks, New York, for leading the way and tackling these troubling third party issues head on … and winning!
A.J. Smith, D.D.S.
Salt Lake City