Aetna, Optum call for rehearing after losing “dummy code” appellate trial

Aetna and Optum issued a petition for a rehearing July 6 after a federal appellate court sided with a lawsuit that claimed the insurers used “dummy code” to make administrative fees appear to be billable medical charges.

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In the petition, the insurers claim judges’ decision to allow plaintiff Sandra Peters to sue would open the floodgates for litigation that wasn’t proven to harm members. In June, judges ruled Ms. Peters did not need to provide evidence she suffered a loss to sue.

Specifically, Aetna and Optum cite US Supreme Court rulings in Thole v. U.S. Bank N.A. and TransUnion LLC v. Ramirez, in which final rulings claimed plaintiffs who did not personally suffer financial losses lacked grounds to sue.

The petition also claims the appellate court miscalculated alleged losses because of  the included administrative fees. Because of the individual nature of some of these calculations, the insurers argue the lawsuit could not be a class-action one.

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