People who didn’t know the late Susan B. Waters or have the opportunity to hear her speak really missed out on one of the leading lights of the insurance...
NEW YORK (AP) — Aetna backed out of a settlement over reimbursement for out-of-network claims, citing the number of eligible people who opted out of that settlement.
The original agreement announced in December 2012 was valued at up to $120 million.
Shares of Aetna Inc. slipped 93 cents to $71.98 Friday.
The case will go back to court, where the health insurer said it will vigorously defend itself.
The class action lawsuit was filed in July 2007 by the American Medical Association and several other groups. Health plan members and providers alleged that Aetna lowered data contributed to a database used to determine "usual and customary" payment rates for care that patients got outside of their insurance network. They said Aetna did so in order to lower its payment obligations.
The U.S. District Court for the District of New Jersey approved the settlement on a preliminary basis in 2013. Aetna had agreed to pay $60 million after final approval, and up to $60 million more after claims were submitted and validated.
The AMA did not immediately respond to a request for comment.