Aetna Defeats Appeal on Denial of Brand-Name Drug Payments

A participant in an Aetna small business group health plan lost her suit to force the insurer to pay in full for a brand-name drug prescription because the contract had a “choose generic” requirement, the Second Circuit said Friday.

Aetna Life Insurance Co. properly won summary judgment in Jacqueline Fisher’s suit alleging the breach of an Employee Retirement Income Security Act contract, the U.S. Court of Appeals for the Second Circuit said.

Fisher’s husband, William Dunnegan, is a name partner at New York’s Dunnegan & Scileppi LLC, which purchased the Aetna plan, the court said. On Jan. 9, 2014, the ...