The lawsuit was filed by Saloojas, an out-of-network laboratory that operates seven specimen collection sites. The company said the insurer is required to fully cover all Aetna Plan members’ COVID-19 diagnostic testing services and issue reimbursements during the public health emergency, regardless of network status.
Saloojas alleges Aetna mis-adjudicated “almost every single” COVID-19 testing claim it submitted on behalf of Aetna plan members and denied a vast majority of COVID-19 testing claims the company submitted.
The company alleges that Aetna’s actions undermined national efforts to mitigate the spread of COVID-19 and caused the company and others to shutter specimen collection and testing locations and potentially stop offering COVID-19 testing services altogether. Saloojas alleged Aetna’s misprocessing and denials have caused the company near insurmountable financial loss.
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.
