Aetna’s Surprise Billing Fraud Case Rejected by Federal Judge

Aetna Health Inc. can’t overturn a series of surprise billing losses to Radiology Partners Inc. because the insurer didn’t challenge the doctor group’s billing practices during arbitration, a federal judge ruled in what he said was a “close call.”

The insurer accused Radiology Partners of abusing the independent dispute resolution process under the No Surprises Act, which protects patients from most unexpected out-of-network bills by requiring insurers and doctors to settle themselves. Aetna sued in December, saying Radiology Partners was illegally funneling arbitration cases from one of its out-of-network practices through its in-network groups.

Judge Brian J. Davis of the ...