HARTFORD, Conn. (AP) — Aetna Inc. (NYSE:AET) could pay up to $120 million under a proposed settlement of federal, class-action litigation over reimbursement for claims outside the insurer’s network of health care providers.
The Hartford, Conn., insurer said Friday that it will pay $60 million, most of it after the settlement receives final court approval, and then as much as $60 million more after claims are submitted and validated. Aetna, the nation’s third-largest health insurer, said it admitted no wrongdoing in agreeing to the settlement.
Aetna plans to take a $78 million, after-tax charge in the fourth quarter because of the settlement, which it expects to be approved by the middle of next year.
The case, In re: Aetna UCR Litigation, MDL No. 2020, which was filed in federal court in New Jersey, involves health plan members and providers suing over Aetna’s out-of-network reimbursement.
The first suit included in the litigation was filed in 2007, according to a report Aetna filed with the U.S. Securities and Exchange Commission (SEC).
The settlement class period for enrollees includes claims filed on and after March 1, 2001, up until the present.
The class period for providers includes claims filed on and after June 3, 2003, up until the present.