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May 29, 2003 at 08:00 PM
NU Online News Service, May 29, 2003, 5:43 p.m. EDT – Aetna Inc., Hartford, has received preliminary approval from U.S. District Court Judge Federico Moreno for a proposed settlement agreement that could resolve litigation with more than 700,000 doctors, according to an announcement from the lawyers who have organized the litigation.
The litigation organizers have filed suits accusing Aetna and other managed care companies of working together to confuse doctors, negotiate unfair provider contracts, and lower and delay payments to doctors in unreasonable ways.
The proposed settlement agreement calls for Aetna to make some changes that could affect employers, benefits administrators and benefits technology companies.
Aetna has agreed to improve the accuracy of information about whether patients actually have health coverage by persuading more employers to transmit eligibility information to Aetna in an electronic format and transmit eligibility information to Aetna more often.
Aetna also has agreed to persuade large benefits administrators to give it more accurate eligibility information. Aetna is supposed to track administrators’ speed at removing terminated plan members from plan eligibility files and help develop systems that will extract eligibility information directly from employer payroll systems.
A direct payroll extraction system should “reduce the turnaround time for transmitting such information and the likelihood for errors,” according to the agreement text.
