Judge dismisses lawsuit over Aetna's spine surgery coverage: 4 things to know

Angie Stewart -   Print  |
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A lawsuit accusing Aetna Life Insurance of wrongly denying coverage for lumbar artificial disc replacement surgery was dismissed by a federal judge, Bloomberg Law reports.

Four things to know:

1. Aetna-insured patients Brian Hendricks and Andrew Sagalongos filed a class-action complaint against Aetna on Aug. 7, alleging that the insurer's practice of denying coverage for lumbar artificial disc replacement violated the Employee Retirement Income Security Act.

2. Aetna denied coverage for the spinal surgery on the grounds that this service is "experimental and investigational," the lawsuit stated. However, the plaintiffs argued that lumbar artificial disc replacement surgery has been FDA-approved for 15 years "and is a safe, effective and often recommended procedure that has successfully treated the symptoms of lumbar disc disease."

3. Judge Cormac J. Carney ruled that the lawsuit didn't include enough specific information. Mr. Hendricks needed to specify the health plan terms that would entitle him to benefits under ERISA, Mr. Carney said. Mr. Hendricks has two weeks to file an amended complaint.

4. UnitedHealth and Anthem have settled similar lawsuits, according to Bloomberg Law.

More articles on spine:
Dr. Sergiy Nesterenko opens spine clinic in Texas
California hospital adds 7 neurosurgeons to curb patient leakage
Drs. Nic Gay, Kerisimasi Reynolds team to form Silicon Valley Orthopaedics 

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