AETNA: Suit Claims Ads Mislead Customers
A New York couple is suing Aetna U.S. Healthcare, "alleging that the company is misleading consumers about the care it approves and financial incentives for doctors." Yesterday's Hartford Courant reported that Irwin and Mara Maltz of North Bellmore, NY, with the assistance of the Blackwell Center for Patient Rights, sued the HMO after seeing a commercial mentioning that Aetna had flown a patient to the Cleveland Clinic for treatment of Crohn's disease. The family claims that the same option was not available to their son, who also suffers from Crohn's. Aetna spokesperson Joyce Oberdorf said the couple's suit is "ludicrous," in that the health plan would only transport someone if care "is not available locally." She said, "Our New York network has some of the premiere medical centers in the country in it, and we find it difficult to believe that this care would not be available in New York." The family also alleges that Aetna's new handbook, "HMO Plan Benefits," misleads customers by saying that capitation is designed to ensure quality care, when in fact the couple contends capitation "often is detrimental to patient care and patient satisfaction." Oberdorf noted that Aetna has an appeals process and that the Maltzes had previously sued the insurer for capitation. "We wonder if they may be professional filers of suits," she said (11/11).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.