Aetna Inc. reaches $120 million out-of-network settlement

December 10. 2012 10:00AM - Last modified: December 10. 2012 10:23AM

Heather Stauffer

Aetna Inc., a national health insurance company that does business in Central Pennsylvania, has agreed to a $120 million settlement related to out-of-network reimbursements.

The settlement resolves litigation in United States District Court for the District of New Jersey centering on Aetna’s use of a certain database from United Healthcare subsidiary Ingenix Inc. to set rates for out-of-network services.

According to a news release, Aetna and other insurers agreed to stop using the database in a 2009 settlement. This new settlement will create three funds from which out-of-network providers and those insured by Aetna may make claims for reimbursement.

“Physicians and medical societies have previously settled very similar claims against United Healthcare resulting in significant relief for out of network healthcare providers,” the release said.

 


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