Given Aetna’s history, Florida should investigate insurer’s claim practices

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Aetna’s checkered history in Florida includes being reprimanded by a federal judge for misleading state regulators about why it was pulling its health care exchange plans from three Florida counties — Palm Beach, Broward and Volusia. Two years ago, an analysis of its Florida health plans revealed Aetna had inflated co-pays to discourage HIV patients from enrolling, in violation of federal laws prohibiting discrimination against patients with pre-existing conditions.

Now, insurance commissioners in at least four states are investigating Aetna after one of its former medical directors revealed the company had trained him to approve or deny claims without reviewing patient medical records. The disclosure was made in California, but given Aetna’s history of misleading Florida regulators, the state should undertake its own review to ensure the company is not engaging in similar practices here.


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