The American Medical Association and several other medical associations have filed a price-fixing lawsuit against leading health insurance provider WellPoint. The suit is one of a series of high-profile cases against insurance providers accusing them of artificially lowering payments to doctors, thereby overcharging patients millions of dollars.
Software billing technology is at the center of the lawsuits. WellPoint and other insurance providers use software to determine how much doctors should be paid for out-of-network treatment and other health services. These programs, pejoratively termed "denial engines," have been at the center of a public controversy between doctors and insurers for several months. Doctors accuse insurers of paying less to doctors for out-of-network patients, while insurers counter that doctors bill much more for those same patients than they do for similar in-network treatment.
The AMA recently settled a similar lawsuit with UnitedHealth, which paid $350 million to the AMA and its partners in January. New York Attorney General Andrew Cuomo recently sued UnitedHealth and Aetna for similar reasons, leading to a combined $70 million settlement toward a database system for a health-related nonprofit.

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