Aetna, Optum See ERISA Claims of Chiropractor Fee Fraud Revived

A participant in a health plan administered by Aetna Inc. on Tuesday convinced the Fourth Circuit to reinstate her proposed class action accusing the company of conspiring with Optumhealth Care Solutions Inc. to overcharge for chiropractic and physical therapy services.

Sandra Peters can seek several forms of relief under the Employee Retirement Income Security Act without showing a personal financial loss tied to the alleged conduct, the U.S. Court of Appeals for the Fourth Circuit ruled.

Her lack of financial loss doomed her individual claim for restitution, but she can press claims for surcharge, disgorgement, and injunctive relief, and she ...