AETNA: New Suit Claims ‘Vital Information’ Withheld
As predicted, a Philadelphia law firm filed a suit in federal court Monday against Aetna, alleging HMO enrollees are held at a disadvantage because the insurer withholds "vital information," such as physician compensation models, and grants doctors financial incentives to "influence their medical judgement." The suit differs slightly from the one announced Monday against Humana Inc., in that it does not accuse Aetna of fraud but charges that under ERISA, the insurer has a "fiduciary duty" to fully disclose benefit information to self- insured employers. Attorneys hope to secure class-action status for the suit, but one observer said that may be difficult as HMO plans vary by employer, and as Aetna may already provide patient information to employers who opt not to share it with employees (Gentry, Wall Street Journal, 10/7).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.