Aetna Health of California beat a lab's proposed class-action lawsuit alleging that the payer evaded its obligations to fully cover COVID-19 diagnostic testing, but the lab will have another chance to bring claims under federal benefits and racketeering laws, Bloomberg Law reported Oct. 3.
The lawsuit was filed in May by Saloojas, an out-of-network laboratory that operates seven specimen collection sites. The company argued 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 alleged 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.
U.S. District Judge Jacqueline Scott Corley said the federal CARES Act does not establish a private right to sue, according to the report.
Saloojas has until Oct. 31 to file an amended complaint, according to court records.