From lawsuits to new partnerships, here are six recent headlines about Hartford, Conn.-based Aetna:
- Aetna sued by plastic surgery provider: The payer is being sued in Florida by Vanguard Aesthetic and Plastic Surgery for an alleged "unreasonably low" reimbursement rate. Vanguard claims Aetna entered a contract by granting an in-network exception for all care for a particular patient, but the payer only reimbursed 3.7 percent of the claim.
- Allina Health | Aetna names new CEO: Former Chief Medical Officer Robert Wieland, MD, is now CEO of the joint-venture health plan that combines Allina Health's providers and Aetna's national benefits.
- Aetna facing class action over physical therapy coverage: The payer allegedly used a restrictive definition of "medically necessary" to avoid covering a patient's physical therapy. It must argue in Connecticut federal court it did not violate the Employment Income Retirement Security Act.
- Supreme Court declines to toss 'dummy code' suit against Aetna, Optum: The nation's highest court upheld a class-action lawsuit that alleges the company worked with Aetna and used "dummy code" to make administrative fees appear as billable medical charges. The class-action is awaiting a final decision in the Fourth Circuit Court of Appeals.
- Aetna, Grow Therapy partner to cover mental healthcare for members: The move provides in-network coverage to all 87 million Aetna members for Grow Therapy's thousands of therapy and psychiatry providers, regardless of location.
- Aetna sued over spinal surgery coverage: An Aetna Life Insurance member is suing the payer for not covering his lumbar artificial disk replacement surgery, arguing the move violates the Employee Retirement Income Security Act.