Yahoo Finance Aetna backs out of $120M legal settlement
Aetna reverses course on $120M settlement of class action lawsuit over out-of-network payments
NEW YORK (AP) -- Aetna has backed out of a legal settlement over reimbursement for out-of-network health claims, citing the number of eligible people who opted out of that settlement.
The original agreement announced in December 2012 was valued at up to $120 million.
The case will go back to court, where the health insurer said it will vigorously defend itself.
The class action lawsuit was filed in July 2007. Health plan members and providers alleged that Aetna lowered payment data contributed to a database used to determine "usual and customary" charges for care that patients got outside of their insurance network.
They said Aetna did so in order to lower its payment obligations.
The U.S. District Court in New Jersey approved the settlement on a preliminary basis in 2013. Aetna had agreed to pay $60 million after final approval, and up to $60 million more after claims were submitted and validated.
The American Medical Association filed a lawsuit in 2009, and that suit was later consolidated into the class action. The AMA says it did not sign the settlement agreement and it is examining Aetna's termination of the settlement.
Shares of Aetna Inc. slipped 99 cents to $71.92 Friday.
