Skip to content
Font Size
A
A
A

As Texas Goes, So Goes the Nation?


WebMD Feature

May 29, 2000 -- The agreement reached last month in the lawsuit brought by the State of Texas against Aetna U.S. Healthcare may have solved the company's problems there, but two other key states, New York and Connecticut, are moving forward with probes aimed at reviewing the insurance giant's practices.

Attorneys general in both states signaled that they will continue their high-profile investigations of Aetna even as the company began taking steps to institute the provisions of its Texas pact nationwide.

Recommended Related to Health Ins & Medicare

Health Care Reform and Children: FAQ

The Affordable Care Act now extends a number of additional benefits to children. WebMD readers have written in with questions about their rights and challenges they’ve faced when trying to insure their young adult children. Here are answers to the most common questions.

Read the Health Care Reform and Children: FAQ article > >

Sued by Texas in 1998 for allegedly using financial pressure to force doctors to cut back on necessary medical care, the company signed a no-fault settlement agreeing to voluntarily change many of its policies there.

Sea Changes in Connecticut

Aetna had hoped it could use the Texas settlement as a model for plans in other states where the policies and protocols of its widely used Health Maintenance Organization (HMO) are under investigative review. But in mid-May, after the company offered to make some changes in its procedures in Connecticut, Richard Blumenthal, the attorney general in that state, would say only that the firm's offer was a "good start." Blumenthal said his office's probe into Aetna's work in Connecticut would continue, and that he wanted the firm to consider changing its practice of paying a set fee for each patient ("capitation"), which, he said, "wrongly shifts the risk of health care to physicians and their patients."

William Donaldson, Aetna chairman and CEO, told a meeting of the Connecticut State Medical Society that his firm hoped its proposals would be given a fair assessment by the state's government and physicians. "My fervent hope is that we can form a more respectful and collaborative partnership that makes the system work better for everyone," he said. And Tim Norbeck, the medical society's executive director, responded that Donaldson's statement was "an indication that Aetna is sincere about wanting to reach out and partner with physicians."

What About New York?

In New York, State Attorney General Eliot L. Spitzer has been noticeably silent on the issue since Texas and Aetna settled. In New York, Aetna is considered the worst of the managed care companies when it comes to paying claims and dealing with providers. In four rounds of fines on the industry over the past 12 months, the New York Insurance Department has hit Aetna with more penalties than any other firm for not paying claims promptly. Officials in Spitzer's office, which has been examining Aetna's procedures for approving or denying claims and the late payment of claims, will say only that the pact does not fully address Spitzer's concerns.

Hot Topics

WebMD Video: Now Playing

Click here to wach video: Dirty Truth About Hand Washing

Which sex is the worst about washing up? Why is it so important? We’ve got the dirty truth on how and when to wash your hands.

Click here to watch video: Dirty Truth About Hand Washing

Popular Slideshows & Tools on WebMD

disciplining a boy
Types, symptoms, causes.
psoriasis
What it looks like.
fruit drinks
Eat these to think better.
No gym workout
Moves to help control blood sugar.
acupuncture needle on shoulder
10 tips to look and feel good.
Close up of eye
12 reasons you're distracted.
Epinephrine Injection using Auto-Injector Syringe
Life-threatening triggers.
woman biting a big ice cube
Habits that wreck your teeth.
embarrassed woman
Do you feel guilty after eating?
pacemaker next to xray
Treatment options.
caregiver with parent
10 tips for daily life.
birth control pills
Which kind is right for you?

Pollen counts, treatment tips, and more.

It's nothing to sneeze at.

Loading ...

Sending your email...

This feature is temporarily unavailable. Please try again later.

Thanks!

Now check your email account on your mobile phone to download your new app.

Women's Health Newsletter

Find out what women really need.