ment administrator to Aetna and class counsel, the opt-out levels exceed the threshold.” Aetna did not provide spe- cific numbers. Attorneys for the plaintiff physicians
are determining whether Aetna has properly terminated the settlement. If that is the case, the class action lawsuits against Aetna will proceed to trial. Physicians who’ve been practicing medicine since 2003 and delivered out- of-network care to Aetna subscribers may be able to join as class representa- tives. If you wish to join the amended lawsuit, email TMA Vice President and General Counsel Rocky Wilcox at rocky .
wilcox@texmed.org, or call him at (800) 880-1300, ext. 1335, or (512) 370-1335. TMA, the American Medical Associa-
tion, and the medical societies of Califor- nia, Connecticut, Florida, Georgia, North Carolina, New Jersey, New York, Tennes- see, and Washington sued Aetna in 2009 over its use of databases licensed from Ingenix, a UnitedHealth Group Inc., sub- sidiary. Ingenix underpaid physicians for out-of-network services, the lawsuit said. It also challenged other ways Aetna de- termined out-of-network payment rates and accused Aetna of failing to disclose how it figured those rates. A patient filed a similar suit in 2007. UnitedHealthcare entered into a $350
million class settlement in 2009 for out- of-network underpayments. Aetna, Unit- ed, and other insurers agreed to stop us- ing the Ingenix database as part of the settlement, which created FAIR Health,
www.fairhealth.org, to take over and im- prove the database and establish trans- parent, current, and reliable health care charge information. For additional information about the settlement, visit the Aetna UCR settle- ment website, http://aetnaucrsettlement .com/
home.html.
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June 2014 TEXAS MEDICINE 13
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