Aetna Lost $10M In Surgical Center's Billing Scam, Suit Says

Law360, New York (May 21, 2013, 3:38 PM EDT) -- Aetna Health Inc. says it has been defrauded out of nearly $10 million by a New Jersey-based outpatient surgical center, which allegedly submitted wildly inflated reimbursement demands that outpaced Medicare guidelines, according to a lawsuit filed Monday in New Jersey federal court.

The health insurance and benefits provider says that Patient Care Associates LLC, which isn't a part of the Aetna network, engaged in a scheme to woo Aetna participants whose plans and policies allowed access to out-of-network benefits and seek reimbursement from Aetna up to...
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