Judge awards Aetna $51.4M in out-of-network billing case against surgical hospital

U.S. District Judge Lynn Hughes awarded Aetna $51.4 million in a seven-year court battle against Humble (Texas) Surgical Hospital, according to Chron. The decision was made before the case was brought to a jury.

In 2012, Aetna sued Humble Surgical Hospital for charging 10-times market rates on out-of-network procedures. The insurance company contended Humble Surgical Hospital offered discounts to out-of-network patients so their fees were similar to in-network patients, but billed Aetna higher rates as an out-of-network provider.

The hospital's lawyer said Humble Surgical plans to file an appeal. Humble Surgical Hospital was involved in similar cases with Cigna, in which the court ruled in Humble Surgical's favor.

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