Aetna Escapes Out-of-Network Surgery Practice’s Antitrust Claims

Aetna Inc. is off the hook for claims that it sought to monopolize the New York health insurance market by stiffing out-of-network doctors and medical practices, a federal judge in Manhattan ruled.

Despite speculating that Aetna slow-walked reimbursement claims as “part of a broader scheme to penalize out-of-network providers” for refusing “to go in-network,” the lawsuit “is bereft of facts” showing “how Aetna’s supposed conduct actually excluded or is likely to exclude competition,” Judge J. Paul Oetken wrote.

He also threw out all but one of the suit’s claims under the Employee Retirement Income Security Act of 1974, saying the ...