AETNA: N.Y. Hospitals Take Aim at Lawsuit-Plagued Insurer
In the latest rash of lawsuits against managed care companies, 24 New York-area hospitals filed suit against Aetna U.S. Healthcare last week, charging the insurer with breaching its contracts with the facilities and violating the state's prompt payment laws, the Wall Street Journal reports. Filed in New York State Supreme Court, the suit charges that Aetna failed to live up to the obligations of its agreement with each facility to treat covered patients. Fred Miller, the attorney representing the hospitals, said, "We're providing services that physicians in the Aetna network have ordered and that the Aetna medical director is second-guessing months after the fact." He said that the retrospective denials had disallowed payments for 20% to 25% of inpatient days at the hospitals. The hospitals are seeking a minimum of $45 million in compensatory damages and $50 million in punitive damages. While Aetna officials had yet to see the suit, they said, "We would strongly disagree with any suggestion that we have intentionally delayed payments in violation of New York Managed Care and Prompt Payment laws." Aetna said it was "disappointed" by the suit and hoped to "resolve these issues with each of these hospitals." Aetna is already dealing with similar claims in other states, including Georgia and Texas (Hensley, 5/31).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.