Related Stories
Ultrasound at $59,490 Is Outrage in Aetna Claim Against Doctors
Key Excerpts from Article on Website of Bloomberg/BusinessWeek
Posted: April 5th, 2011
http://www.businessweek.com/news/2011-03-24/ultrasound-at-59...
Aetna Inc. is suing six New Jersey doctors over medical bills it calls unconscionable, including $56,980 for a bedside consultation and $59,490 for an ultrasound that typically costs $74. The lawsuits could help determine what pricing limits insurers can impose on out-of-network physicians who dont have contracts with health plans that spell out how much a service or procedure can cost. One defendant billed $30,000 for a Caesarean birth, and another raised his fee for seeing a critically ill patient in a hospital to $9,000 in 2008 from $500 the year before, the insurer alleges in the suits. Aetna tried in 2007 to impose caps on some out-of-network payments, prompting doctor complaints to the New Jersey Department of Banking and Insurance. The agency sided with the doctors, fined the company $2.5 million, and ordered it to pay out-of-network practitioners enough so that patients wouldnt be asked to pay balances other than co-pays. In 2009, Aetna, UnitedHealth Group Inc., Cigna Corp. and WellPoint Inc. were accused by the New York attorney general of underpaying out-of-network physicians by manipulating a database used to calculate payments. They paid a total of $90 million in settlements without admitting wrongdoing. UnitedHealthcare agreed that year to pay $350 million to settle a lawsuit by the American Medical Association over the same issues. Similar AMA lawsuits against Aetna, Cigna and Wellpoint are pending.
Note: Is the American health care system out of control? For lots more from reliable sources on corporate corruption, click here.
Related Stories
Latest News
Key News Articles from Years Past
