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Aetna Wins $37.4M Jury Verdict Over Medical Billing Fraud

Law360, Los Angeles (April 14, 2016, 10:42 PM EDT) -- A California jury awarded Aetna Inc. over $37.4 million in damages Wednesday after finding a network of Northern California surgical centers overbilled the insurer for out-of-network procedures through a complex scheme in which referring physicians received substantial kickbacks.

The victory capped a monthlong trial and four years of litigation against 10 defendants, including the centers, Bay Area Surgical Management LLC and the organization’s three co-founders.

The surgical centers recruited patients by offering waivers of co-pays and other fees and through selling shares in the facilities to referring physicians who received handsome returns on their investments, in addition to their own fee...

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