The settlement allows 142 patients who were denied proton beam therapy treatment between June 2017 and October 2020 to receive cash payments of up to $24,000, according to the report. Each class member who submits a timely and valid claim form will receive a minimum of $10,000.
The proposed class-action lawsuit argued Aetna wrongly denied coverage of proton beam therapy when it argued the treatment was experimental and investigational, according to the report. After the lawsuit was filed, Aetna revised its coverage guidelines, expanding the list of conditions for which it considered proton beam therapy appropriate treatment.
The agreement is subject to approval by Eastern District of Pennsylvania Judge Cynthia Rufe.
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