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Member, Beacon International Group, Ltd.
NEW YORK--The New York Attorney General's office has asked a UnitedHealth Group Inc. unit to cease the implementation of a program to rank doctors according to quality and cost effectiveness.
The attorney general is prepared to seek an injunction if the insurer fails to comply with the request to halt the introduction of the Minnetonka, Minn.-based insurer's "Premium Designation" program in New York, according to a letter sent to the insurer's UnitedHealthcare unit.
The program evaluates care delivery by physicians across 19 medical specialties using science-based, industry-standard criteria and guidance from medical specialty societies and expert physicians, according to a press release issued by the insurer last year.
The program would apparently be used to direct consumers to doctors based on these ratings and may be used by employers offering financial inducements such as lower copayments and deductibles to promote cost-effective doctors, according to the letter.
The attorney general's office expressed concern that consumers may be steered to doctors based on "faulty data and criteria" and may be encouraged to choose doctors based on price rather than quality, which "could undermine the integrity of the doctor-patient relationship."
The insurer's profit motive may affect the accuracy of its quality rankings because high-quality doctors may be more expensive, which would be a conflict of interest, according to the attorney general's office.
"We believe that such a program would have a strong likelihood of causing consumer confusion, it not deception," the letter stated.
The letter, sent Friday, gave the insurer two business days to inform the attorney general's office whether the insurer intends to comply with the request.
UnitedHealth could not be immediately reached for comment.