Aetna agrees to pay doctors, patients $120 million
Hartford-based Aetna Insurance Co. has agreed to settle a class action lawsuit filed by doctors and patients who say the health insurer used a flawed system to pay claims.
The settlement, filed in a New Jersey federal court Friday, requires Aetna to pay affected doctors and policyholders $120 million.
The Connecticut State Medical Society, which joined the American Medical Society and other state medical societies in bringing the lawsuit, said the settlement "represents years of hard work" by the doctors' associations to "correct artificially low payments" to out-of-network doctors. The lawsuit also says patients were forced to pay more out-of-pocket for care.
The blame, the doctors say, lies in the use by Aetna and many other insurers of a database called Ingenix, which the doctors say is flawed.
United Healthcare and HealthNet have settled similar suits involving Ingenix, and similar cases against Cigna and WellPoint are pending.
Aetna spokeswoman Cynthia Michener said the settlement is "no admission of wrongdoing."
"Aetna is pleased to resolve this longstanding litigation with members and providers, both of whom are important constituents," Michener said.