INSURANCE UNDERPAYMENTS August 2011 American Society of Addiction Medicine redefines addiction as a chronic brain disease, not a behavioral problem. California housing law that considers as a “family” up to 6 people with the same affliction living in the same house. New Jersey District Court 2008 Decision that required Health Net to pay $250,000,000 in sanctions and for use of Ingenix, a “faulty” for profit data base that resulted in underpayments to Health Net insured who used an out-of-network provider. “The Consumer Reimbursement System is Code Blue,” a January 2009 investigation into Ingenix by the New York Attorney General that resulted in lawsuits against all the major health insurance companies for underpaying out of network providers buy millions of dollars. “Underpayments to Consumers by the Health Insurance Industry,” a June 2009 investigation into Ingenix by the US Senate Commerce Committee that determined consumers across the United States had been forced to pay billions of dollars to out-of-network providers that should have been covered by their insurance policies. The New York Attorney General uses settlement monies from the Ingenix lawsuits to create Fair Health, a non-profit database, independent of the insurance companies, to determine Usual, Customary and Reasonable (UCR) rates for out-of-network providers. Only problem: None of the major health insurance companies are using Fair Health to determine UCR for California’s for profit, out of network addiction facilities. Definition of UCR from the California Insurance Commissioner’s website New York Attorney General Finds DataIsight, owned by Multiplan, underpaid UCR rates to Employees and Retirees whose health plans AXA self-funds, in violation of the plan benefits.