Aetna Agrees to $120M Settlement to Out-of-Network Physicians

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Aetna has agreed to pay up to $120 million to settle a suit accusing the insurer of underpaying physicians for out-of-network services, according to a Law360 report.

The provider class suit was originally filed in 2009 to recover owed payments and challenge how the insurer calculated its out-of-network rates, according to the report. Plaintiffs included the American Medical Association as well as 10 statewide medical societies.

From the total settlement of $120 million, $60 million will be used to cover the plaintiffs' legal fees and providers without documentation detailing the amount owed to them by Aetna, and an additional $60 million will cover claims by providers and plan members with documentation of money owed, according to the report.

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