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Be your company’s conscience

Bill Coffin | February 12, 2018

Health insurance giant Aetna is under investigation in California after one of its former medical directors, who had the power to approve or deny insurance coverage for millions of people, admitted that he never looked at patients’ medical records when making a decision on whether or not to approve a claim.

The admission was made under oath and as part of a lawsuit filed against Aetna over its refusal to pre-pay for infusions a patient needed to combat a low immunity syndrome. The outcome of that lawsuit is uncertain, but Aetna has already publicly stated that its medical directors are trained to review medical files on patients and that they take their duties very seriously. We shall see how much water that holds with California’s insurance commissioner, which is already noting that denying health insurance claims without consulting medical information is at least a... To get the full story, subscribe now.