In a June 8 news release, Comptroller Brad Lander said the pending litigation “calls into question the legality” of the contract, which would provide health benefits to 250,000 retired municipal employees and dependents.
In a lawsuit filed in New York County Supreme Court May 31, nine retirees and the NYC Organization of Public Service Retirees allege providing Medicare Advantage as the only option for retirees violates the city’s obligation to provide health benefits to its retired workers.
In the lawsuit, the retirees alleged they could face coverage denials, out-of-pocket costs and lose their current providers if they are not in Aetna’s Medicare Advantage network.
In the news release, Mr. Lander said the “broader Medicare Advantage trends are worrisome,” citing allegations that most major payers have overcharged the federal government.
“As a matter of public policy, beyond the scope of our office’s specific [city] charter responsibility for contract registration, I am seriously concerned about the privatization of Medicare plans, overbilling by insurance companies, and barriers to care under Medicare Advantage,” Mr. Lander said in the news release.
Becker’s reached out to Aetna for comment and will update this article if more information becomes available.
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.