Aetna sued again over claims denial
Aetna’s legal department remains busy. Days after the company settled out of court with a patient who sued for coverage denial in California, it’s in the news in Florida for much the same reason—but with a bigger claimant.
The Ledger of Lakeland is reporting that Lakeland Regional Health, which operates the fifth largest hospital in the Sunshine State, wants more than $1 million to compensate for what it calls arbitrary denials of patient claims related to readmissions.
The figure includes interest and legal fees, and the case is now in a federal court.
An attorney for the health system said it’s been giving Aetna a chance to resolve the issue since 2017.
“Many of the readmissions which have been denied by Aetna are patients who are chronically ill with many comorbidities,” Lakeland’s complaint states. “As such, the cases are complex and cannot be cavalierly denied as Aetna has done under the guise of its policy.”
Aetna countered by filing to have the lawsuit dismissed on April 26.
“The readmissions policy is designed to prevent a facility, like Lakeland, from failing to provide appropriate and complete care as part of an initial hospital admission,” Aetna’s attorneys said in a statement. “If the conditions had been properly treated as part of the initial admission, the second admission would not be necessary.”
The news comes as Aetna’s new parent, CVS Health, reports a big jump in revenues.
Click below to read the full news item on the Lakeland lawsuit.
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.