Texas fines Aetna
The Texas Dept. of Insurance fined Aetna $1.15 million for violating the state's prompt-payment laws and ordered the company to pay restitution to physicians and hospitals for claims filed from Aug. 1, 2000, to Oct. 1, 2001, that were not properly paid.
Aetna agreed to the order without admitting any violation of Texas law.
The state said Aetna had failed to pay 85% of disputed claims while conducting audits and that it had failed to maintain proper complaint records.
Aetna Life Insurance, Aetna US Healthcare, Aetna US Healthcare of North Texas and Prudential Health Care Plans have 60 days to pay restitution to doctors and hospitals for clean claims that were not paid within 45 days, claims paid after the 45th day of receipt and clean claims that were not paid correctly.
Aetna US Healthcare of North Texas faces an additional fine of $600,000 if it fails to satisfy voluntary payment arrangements with physicians and others associated with the now-bankrupt Medical Select Management.
Back to top
Copyright 2001 American Medical Association. All rights reserved.
