Consent Agreement Order.pdf

19-213.pdf
Preview of Consent Agreement Order
🔗 Source: maine.gov
📊 Size: 278 KB
📄 Pages: 6 pages
⬇️ Downloads: 55

Summary

Aetna Life Insurance Company and Aetna Health Inc. entered into a Consent Agreement with the Maine Bureau of Insurance to resolve violations of the Maine Insurance Code related to processing claims involving routine newborn care. Aetna failed to treat mothers and newborns as one person when calculating cost-sharing, violating 24-A M.R.S. § 2834-A and § 4234-B. Aetna acknowledged the errors, adjusted claims, and implemented new procedures. Aetna reworked 3,117 claims, issued refunds totaling $1,665,607.90, and paid $361,477.70 in interest. Aetna agreed to a $150,000 civil penalty, which will be suspended if Aetna complies with Maine law during a one-year review period.

Description

Aetna Life Insurance Company and Aetna Health Inc.

Technical Information

  • File Format: PDF
  • File Size: 278 KB
  • Pages: 6
  • Language: EN
  • Total Downloads: 55
  • Last Updated: 1 week ago

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