Aetna HMOs to Expand Outside Case Review

Aetna U.S. Healthcare said it intends to allow members to appeal to a panel of outside doctors if they are denied treatment based on medical necessity. Such a process is already required in 18 states, and all of California’s HMOs have said that they will voluntarily begin to offer outside review by the end of 1999. The unit of Hartford, Conn.-based Aetna Inc., the nation’s largest health insurer, said that its review process will be open to members in all 30 states where it does business. The company said it hopes to launch the program by July 1. Legislation mandating review panels in California is expected to be introduced this year. Aetna shares closed at $89, down 88 cents, on the New York Stock Exchange.