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Aetna sued under anti-racketeering law Posted 4-26-99 In the first suit of its kind since a key Supreme Court ruling, the Foundation for Taxpayer and Consumer Rights filed a class-action lawsuit against Aetna April 19. The suit alleges widespread fraud in the insurer’s public messages and is the first federal case brought since the Supreme Court ruled Jan. 20 that healthcare corporations could be sued for damages under federal anti-racketeering laws. "HMOs have been immune to prosecution, and when we compare their performance to their advertising, there are gross inaccuracies," said Jamie Court, advocacy director for the Santa Monica, Calif.-based foundation. Aetna spokespersons say they were surprised by the case and had no contact with the foundation before the filing. "We feel very strongly that the lawsuit is baseless and wholly without merit," said Joyce Oberdorf, an Aetna spokesperson. The suit alleges that while Aetna emphasizes quality care in its marketing and advertising messages, the company’s actions and policies threaten patient care. Among the complaints noted in the suit are restrictions of medical services, financial incentive programs driven by cost reductions, and highly restrictive physician contracts. "Aetna promises that it is dedicated to improving quality, and yet its procedures, processes, and contracts actually undermine quality care," Court said. "Through discovery [on this case] we are going to be able to show that HMOs are giving misleading information and ... if we succeed, HMOs will have to change their practices." Related Sites |