Aetna Settlement Information
Questions about the settlement may be directed to Whatley Drake & Kallas, L.L.C., at (866) 809-8003.
The following documents will help you understand your rights under the Aetna settlement agreement.
- How the Aetna Settlement Agreement helps the physician practice flyer contains a summary of the key business practices mandated in the Aetna settlement. Since contracts provided by Aetna to physicians in its provider network must conform to the settlement, physicians are encouraged to review their contracts to ensure they are receiving available protections.
- Aetna Compliance Dispute Resolution and Retroactive Medical Payment Policies
- Codes to be reprocessed when billed with an E/M Code appended with Modifier 25
- Important Message Regarding Aetna's Payment Policy for Urinalysis Dipstick and Pulse Oximetry When Billed with Evaluation and Management Codes (E/Ms) Appended with Modifier 25.
- Important Message Regarding Aetna’s Payment Policy for Modifier -57 for Evaluation and Management (E/M) Services at Which Decision for Surgery Is Made
Date settlement reached by parties: May 21, 2003
Final approval date: Oct. 24, 2003
Value of settlements: In excess of $470 million
Retrospective relief: $120 million
- $100 million to settlement fund
- $20 million to Foundation
Prospective relief: $300 million
Compliance dispute facilitator (CDF)
Cameron C. Staples
Neubert Pepe & Monteith, PC
195 Church Street
Phone: (203) 821-2000
Fax: (203) 821-200
To learn more about foundations created by the settlements, please go to the Physicians Foundation Web site.
Please see the HMO Settlements Web site for more information regarding the Aetna Settlement.