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Aetna can't undo class in disc replacement lawsuit

By Admin | July 31, 2023

Aetna lost its bid to decertify a 239-person class-action lawsuit over its coverage of lumbar total disc replacement. 

The insurer based its motion to decertify from Wit v. United Behavioral Health, according to court documents filed in the 9th Circuit on July 25. That case reversed certification of a class of health plan patients seeking to "reprocess" their benefit claims, according to Bloomberg Law

However, Judge Cormac Carney sided with plaintiffs in the disc replacement lawsuit.

"Aetna's denial of coverage for lumbar ADR grounded in company policy communicated in essence that exhaustion of administrative appeals would not yield a different coverage determination, thus rendering exhaustion a vain and useless act and, accordingly, excusing satisfaction of the condition," the order...(More)

For more info please read, Aetna can't undo class in disc replacement lawsuit, by Becker's Spine Review

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