HCA hospitals win $150M in arbitration against Aetna

An arbitrator awarded Florida hospitals owned by Nashville, Tenn.-based HCA Healthcare $150 million in out-of-network emergency room payments from Aetna, the health insurer revealed in a Securities and Exchange Commission filing.

Aetna was named as a respondent in the arbitration proceeding Oct. 28. The proceeding was the result of a lawsuit the hospitals filed in Florida court Aug. 25, 2015. The HCA-owned hospitals' arbitration proceeding concerned Aetna's out-of-network and administration practices in Florida for its individual ACA exchange products from 2014-16. Aetna largely exited the individual exchange business at the end of 2016.

The arbitrator awarded the claimant hospitals roughly $150 million Oct. 15. In its SEC filing, submitted Oct. 30 with Aetna's third quarter earnings, the health insurer said it intends "to continue to defend ourselves vigorously against the claimant hospitals' claims and to appeal the arbitrator's decision."

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