Aetna to pay up to $120M to settle suits related to out-of-network reimbursement

theflyonthewall.com

Aetna disclosed in a regulatory filing that it entered into a settlement agreement to settle purported class action litigation regarding its practices related to the payment of claims for services rendered to Aetna members by health care providers with whom Aetna does not have a contract. Under the settlement agreement, the company will pay $60M, the substantial majority of which will be payable upon final court approval of the settlement, and pay up to an additional $60M at the end of a claim submission and validation period that commences upon final court approval of the settlement. In connection with the proposed settlement, the company expects to record an after-tax charge to net income of approximately $78M in Q4, to be recorded as an "other item." The charge will not affect the company's operating earnings, Aetna said. The company will pay for the settlement with available resources and expects the settlement payments to occur over the next twelve to twenty-four months, it stated.

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