In CMS
Oct 10th, 2018
The Department of Justice preliminary OK’d the merger between pharmacy giant CVS and insurance stalwart Aetna. What does this new model of healthcare mean to medical coders and the industry? CVS & Aetna Symbiotic Partners Aetna will take advantage of CVS’ huge network of locations, all of which distribute pharmaceuticals and most of which have some level ...
In Billing
Sep 28th, 2018
Patients may be asking providers’ staffs, including medical coders, about Aetna’s plan to sell its Medicare Part D drug plan business to WellCare Group. And providers’ staff should also stay on top of the change. Part D Sale to Help CVS Merger Aetna’s sale will affect 2.2 million members as of June, according to CNBC, but ...
May 31st, 2018
Aetna, bruised by a PHI breach where letters detailing a lawsuit settlement were sent to HIV-positive members revealing their status, is now suing the plaintiffs in the original 2014 class action lawsuit  for $20 million, blaming a consumer advocacy group and law firm for their woes. Aetna demands $20 million and indemnification from any actions related to the breach. ...
Feb 13th, 2018
Here’s a stark reminder of the responsibilities  – and risks – of being a business associate: Aetna is suing the company that mailed 12,000 envelopes last summer revealing the recipients had HIV for $20 million and more. Aetna hired claims administrator Kurtzman Carson Consultants (KCC) to send letters notifying Aetna members of a settlement the ...
Feb 13th, 2018
Aetna is under investigation in California for allegedly not following protocol when making coverage decisions. One Aetna member, Gillen Washington, 23, claims it nearly cost him his life. Washington is suing Aetna for breach of contract and bad faith, according to CNN. Case for the Plaintiff Washington, who has common variable immunodeficiency (CVID), claims Aetna ...