The Los Angeles County Medical Association (LACMA), California Medical Association (CMA) and a coalition of health care organizations and providers filed a lawsuit against Aetna Health of California last week.
The lawsuit, filed in Los Angeles County Superior Court, alleges a systematic practice by Aetna of threatening patients with denial of promised coverage if their members see doctors outside the Aetna network of providers, and threatening doctors with having their Aetna contracts terminated if those doctors refer patients outside the network. The insurance company has carried out both these threats in many cases, according to the suit.
Joining LACMA and CMA as plaintiffs are the Santa Clara County Medical Association (SCCMA) and Ventura County Medical Association (VCMA), along with more than 60 physicians, four surgery centers, and a California man who was denied reimbursement for much-needed surgery by his doctor.
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