California
launches investigation following stunning admission by Aetna medical director:
(CNN)California's
insurance commissioner has launched an investigation into Aetna after learning
a former medical director for the insurer admitted under oath he never looked
at patients' records when deciding whether to approve or deny care.
California
Insurance Commissioner Dave Jones expressed outrage after CNN showed him a
transcript of the testimony and said his office is looking into how widespread
the practice is within Aetna.
"If the
health insurer is making decisions to deny coverage without a physician
actually ever reviewing medical records, that's of significant concern to me as
insurance commissioner in California -- and potentially a violation of
law," he said.
Aetna, the
nation's third-largest insurance provider with 23.1 million customers, told CNN
it looked forward to "explaining our clinical review process" to the
commissioner.
