1. The Office of the Inspector General for HHS alleged in audits published Sept. 25 that subsidiaries of Aetna and Humana received millions in Medicare Advantage overpayments in 2017 and 2018. The OIG estimated that HealthAssurance Pennsylvania, an Aetna subsidiary, received $4.2 million in overpayments in that period of time.
2. Aetna is facing a class-action lawsuit alleging that they improperly denied gender-affirming care. The plaintiffs in the lawsuit, filed in federal district court in Connecticut Sept. 10, are three transgender women who allege they were denied coverage for gender-affirming facial reconstruction surgery by Aetna.
3. Aetna and HCA Healthcare hospitals in Florida reached a new contract agreement, avoiding a divide that would have left 48 hospitals out-of-network. The agreement will keep commercial, individual and Medicare Advantage members in network at all HCA facilities in Florida.
4. Aetna Utah was included in a list of 20 payers requesting the largest raises for ACA premiums in 2025. The requested rate increase was 26.6%.
5. Aetna reached an in-network agreement with Renton, Wash.-based Providence to keep commercial members in Washington in network. The deal avoided a split that would have affected about 35,000 people.
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