Pediatrix Accuses Aetna Of Pressure To Lower Claims

Law360 (April 23, 2018, 4:29 PM EDT) -- National pediatric services provider Pediatrix Medical Services Inc. on Friday sued Aetna Inc. in Texas state court and Florida federal court, alleging that the insurer has engaged in a systematic scheme to pressure and manipulate medical providers to reduce claims payments.

Claiming unspecified millions in damages, Pediatrix doctors in the two states and the company's affiliated billing entity Magella Medical Associates Billing Inc. say Aetna has used its "sheer size and enormous market power" as leverage and threatens medical providers with "frivolous lawsuits based on flawed statistical analyses of the providers' claims for payment." The insurer's statistical analysis of medical claims...

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