UPenn Suit Over Aetna Policy Belongs in Court, Panel Says

Law360, Philadelphia (November 4, 2013, 6:39 PM EST) -- The Pennsylvania Superior Court ruled Friday that a lawsuit accusing Aetna Inc. of improperly adjusting insurance claims to reduce reimbursements to the University of Pennsylvania Health System and Presbyterian Medical Center involved allegations of an ongoing scheme that did not belong in front of an arbitrator.

A three-judge panel found that the plaintiffs' demands that a judge order Aetna to cease relying on an audit policy they claimed was used to artificially depress their reimbursements for medical treatment fell outside of an arbitration clause in the agreement between the two parties.

The panel rejected arguments that the University of Pennsylvania and...

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