Aetna Wins $8.4M For ER Billing Fraud Conspiracy

Law360, New York (August 20, 2014, 7:08 PM EDT) -- A Texas federal judge on Wednesday ruled that Aetna Life Insurance Co. can take $8.4 million from three health care providers, for defrauding the insurer of millions of dollars by wrongfully posing as emergency rooms to bill it at inflated rates.

U.S. District Judge Lynn N. Hughes said that Aetna will take the funds from Cleveland Imaging and Surgical Hospital LLC, Trinity Healthcare Network, ER DOC 24/7 PLLC and Premier Emergency Room and Imaging. The judge said the hospital sold the right to use its license-derived billing codes in 2011 to the clinics in exchange for a 15 percent cut of...

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