The following has been released by the
Aetna has agreed to a
Aetna licensed the Ingenix database to determine payment for out- of-network services. The Ingenix database, however, allegedly was flawed and consistently understated what is known as the "usual, customary and reasonable" (UCR) reimbursement rate. The UCR is supposed to represent the "going rate" that health care professionals charge for their services in a particular geographic area of the country.
These allegations were the basis for a class action lawsuit against Aetna filed in 2009 by providers, policy holders and health professional associations, including the
Additional class action suits against other companies that used the Ingenix database are still pending. They include a case in which the
"We hope that cases like these will result in fairer reimbursement practices by the insurance companies and ultimately create greater access to mental and behavioral health services for patients," said
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