U.S. District Judge Federico Moreno in Miami has approved Aetna's class action settlement agreement with physicians, the Hartford, Conn.-based company says.
Under the settlement, approved by Moreno on Friday, Aetna will pay $100 million to doctors, $50 million in plaintiffs' legal fees and expenses and $20 million for a new healthcare foundation run by the 19 plaintiff medical societies.
It also will make changes in payment administration and physician relations valued at about $300 million.
But money aside, physicians' groups have long stated they were more interested in reforming Aetna's payment practices, particularly the coding edits that bundle and downcode claims.
"The settlement initiates meaningful and necessary improvements that represent a positive change in how an industry-leading health insurer does business with physicians," says Donald Palmisano, M.D., president of the AMA, which was not party to the lawsuits but worked closely with the plaintiff medical societies.
"An agreement of this scope represents a progressive development in the push to end the unfair business practices of the managed care industry that have plagued physicians and their patients for years," he says in a release.
John Rowe, M.D., Aetna chairman and CEO, says the settlement begins "a new era of cooperation between Aetna and physicians."
"Our ongoing business practice initiatives and heightened levels of transparency will give physicians and their office staffs more time to focus on their central mission--providing health care to patients," Rowe adds in a release. "This agreement will reduce administrative complexity and lead to changes in the health care system that will ultimately benefit patients."