Insurers Being Sued by More Doctors
Aetna Inc., Cigna Corp., Oxford Health Plans Inc. and other health insurers are being sued by the Medical Society of New Jersey, which accused the companies of denying or delaying payments for medical care.
The lawsuits allege the managed-care companies improperly overrule physicians on whether a treatment is medically necessary, don’t explain why claims have been denied and use computer programs to cut or deny doctors reimbursement.
New Jersey’s medical society is at least the fifth to sue health insurers in state court.
Similar cases have been brought in Connecticut, New York, South Carolina and Tennessee.
Insurers also face federal lawsuits that allege health maintenance organizations put profit ahead of patients. Doctors in Florida, California, Texas and Georgia have joined those suits.
Aetna and Cigna, the second- and third-biggest U.S. health insurers, Health Net Inc., Oxford and AmeriHealth HMO of New Jersey Inc. are named in the lawsuits. The insurers deny the accusations.
