Coalition of physicians, organizations in California wage legal war with Aetna

July 25, 2012

California physicians and two prominent medical organizations filed suit against Aetna claiming that the company denies patients access to physicians outside of its network.

California physicians and two prominent medical organizations filed suit against Aetna claiming that the company denies patients access to physicians outside of its network. The class action lawsuit includes thousands of physicians as well as the California Medical Association and the Los Angeles County Medical Association. Recently filed in the Los Angeles County Superior Court, the lawsuit alleges the company threatened doctors with terminating Aetna contracts if they refer outside of the network and allegedly threatened patients with denial of coverage if visiting doctors outside of its provider network.

Aetna counters the action was filed in retaliation to litigation brought against some of the same physicians spearheading the class action lawsuit for inflated billing practices.

The most recent lawsuit seeks an immediate injunction against Aetna, an end to the practice, compensatory damages to patients and physicians, and punitive damages. The lawsuit accuses Aetna of false advertising, breach of contract, unfair business practices, and both intentional and negligent interference with healthcare providers.