Aetna/CIGNA Class Action Settlements: Impact on Hospitals, Surgery Centers and Other Providers

March 04, 2004

Managed care contracting and business practices between industry powerhouses Aetna and CIGNA and physicians resulting from the settlement of class action lawsuits brought by dozens of physicians, local medical societies and state medical associations are expected to provide a fix to significant problems in the claims processing and reimbursement process.  The lawsuits alleged that Aetna and CIGNA improperly manipulated claims procedures or fraudulently misrepresented the criteria for coverage determination, treatment decisions and payments.  The two settlements are touted as enhancing communication and collaboration, incorporating new levels of transparency regarding payment, and reducing administrative complexity in the claims system.

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