5th Circ. Rules Aetna Can't Sue Texas Hospital Over Billing

Law360 (August 1, 2018, 4:22 PM EDT) -- The Fifth Circuit has ruled that Aetna Life Insurance Co. can't sue an out-of-network Texas hospital for misrepresenting its billing practices, saying Aetna could not claim it was unaware of what those billing practices were.

In a mixed opinion on Tuesday, a three-judge panel affirmed a ruling from the Southern District of Texas saying North Cypress Medical Center, or NCMC, had informed Aetna of a discount it offered to out-of-network patients and Aetna had repeatedly performed its own investigation of the hospital, therefore it couldn't claim it had to rely on NCMC's word for how it billed those patients.

"Aetna contends...

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