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Inquiries into Aetna claims review practices not likely to derail CVS merger

Californias investigation, which prompted Colorados heightened interest in the matter, came after CNN showed California Insurance Commissioner Dave Jones a transcript of a deposition of one of Aetnas former medical directors.

By Kristen Rasmussen | Updated on February 19, 2018
In a statement, Hartford, Connecticut-based Aetna said that medical records were, in fact, an integral part of the clinical review process. (Photo: Shutterstock)

Although two states recently announced that they are taking a close look at Aetna Inc.’s practices for denying claims for health care coverage, the scrutiny is unlikely to prevent the insurance giant’s proposed merger with CVS Health from going through, corporate lawyers said.

California Insurance Commissioner Dave Jones announced Monday the opening of an investigation into Aetna’s claims denial process, its requests for prior authorization for care, and its utilization review process. Later that afternoon, Colorado Interim Insurance Commissioner Michael Conway said that his office would be making inquiries about whether Aetna’s procedure for appealing the denial of coverage for a medical procedure complies with Colorado law governing the issue.

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