Aetna settlement seeks to repair rift with physicians

A federal judge has given initial approval to the agreement while other insurers vowed to keep fighting lawsuits brought by physicians.

By Damon Adams, AMNews staff. June 16, 2003.

Medical societies and attorneys behind the $170 million Aetna settlement with about 700,000 physicians say the agreement has a much bigger reward than the average $142 payment each doctor will get.

They say the settlement, given preliminary approval by a federal judge last month, will improve how one of the nation's largest managed care firms does business with doctors.

Physicians should see fewer administrative hassles, simplified claims processing and procedures, a clear "medical necessity" definition and speedier payments from Aetna.

"[Aetna] is the first and only insurer to step up and attempt to make this managed care system fair and equitable for physicians to navigate. This may not be perfect, but it is a tremendous step in the right direction," said Tim Norbeck, executive director of the Connecticut State Medical Society, one of 19 medical societies that made the settlement with Aetna.

The settlement of the class-action lawsuit, which was filed by the medical societies and individual doctors, calls for Aetna to pay $100 million to doctors and use $20 million to create a foundation to improve the quality of health care by reducing medical errors and racial disparities in treatment. About $50 million will go to the doctors' attorneys.

Aetna also said it would make practice changes to improve how it reimburses physicians and approves treatment, changes estimated to be worth $300 million to physicians over several years. A final hearing on the settlement is set for Oct. 14 in Miami.