Aetna Changing Its Ways
May 13, 2001
Aetna is considering settling the massive class action lawsuit filed against it alleging fraud and racketeering. Aetna patients sued the giant HMO in an attempt to force the company to stop offering its doctors incentives to limit patient care. The class action lawsuit also seeks to limit the industry practice of capitated fees, a payment system that allegedly discourages doctors from ordering additional tests or authorizing referrals to specialists. The plaintiffs allege that such practices harm patient care as important medical services are forgone in favor of saving a few dollars.
While Aetna is considering some of the settlement proposals, it has flatly rejected others. Further bickering could derail the settlement negotiations. However, the company, in a statement by new CEO Doctor John W. Rowe has "concluded that some of the processes we have been using are no longer effective and, in fact, may be counterproductive." Doctor Rowe has been praised for attempting to change Aetna's reputation as a cost cutting and penny-pinching insurer, to one that puts patient care ahead of earnings.
Other insurers and HMOs have not been so eager to change. "We have always felt that these lawsuits have no merit and we still feel that way," said David Olson, a spokesman for Health Net Inc., another insurer involved in the lawsuit.
-- Article Courtesy of InjuryBoard.com
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