Aetna Needn't Pay $13M Owed By Processor: Texas High Court

Law360, Houston (April 19, 2013, 7:30 PM ET) -- Texas’ highest court on Friday ruled that Aetna Inc. is not responsible for $13 million owed to a state hospital system after the insurer’s third-party claims administrator went bankrupt, because the hospital did not have a contractual relationship directly with Aetna.

The high court held that the Christus Health Gulf Coast hospital system cannot seek penalties against Aetna under the Texas Prompt Pay Statute over some 6,000 unpaid claims, because its contracts were with the insurer’s bankrupt claims administrator, North American Medical Management of Texas....
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