Aetna, one of the HMOs cited in the New Jersey study, also does business in southern Ohio and northern Kentucky, where it has 17,000 members. The investigation, completed last year, came after the Ohio Medical Association reviewed HMOs in the state and found they had a poor track record of settling claims on time. The companies that were fined and ordered to submit corrective action plans to ODI within 30 days are SummaCare, Kaiser Foundation Health Plan, Medical Mutual of Ohio, United Healthcare Insurance Company of Ohio, Medical Insurance Company of Ohio, Employers Health Insurance Company and Hometown Health Plan. The Medical Society of New Jersey study tracked medical claims from Aetna, Amerihealth, Cigna, Horizon, Physicians Health Services and Oxford. Following its study, the group asked the state's Department of Banking and Insurance to audit the six HMOs.
Audit is the only language HMOs understand.