Gillen Washington, 23, is suing Aetna for breach of contract and bad faith, saying he was denied coverage for an infusion of intravenous immunoglobulin (IVIG) when he was 19.
#Aetna timely filing for appeals trial
The case is expected to go to trial later this week in California Superior Court.
The deposition by Aetna’s former medical director came as part of a lawsuit filed against Aetna by a college student who suffers from a rare immune disorder. Gillen Washington, 23, says he hopes to force change at Aetna.
He recently served on the academy’s board of directors. Andrew Murphy, who, like Irani, is a renowned fellow of the American Academy of Allergy, Asthma and Immunology. “This is potentially a huge, huge story and quite frankly may reshape how insurance functions,” said Dr. Irani is a professor of pediatrics and internal medicine at the Children’s Hospital of Richmond at VCU and a former member of the American Board of Allergy and Immunology’s board of directors. Anne-Marie Irani when told of the medical director’s testimony. Are you serious? That is incredible,” said Dr. Members of the medical community expressed similar shock, saying Iinuma’s deposition leads to questions about Aetna’s practices across the country. The insurance commissioner said Californians who believe they may have been adversely affected by Aetna’s decisions should contact his office. “That’s why we’ve contacted Aetna and asked that they provide us information about how they are making these claims decisions and why we’ve opened this investigation.” “It’s hard to imagine that in that entire course in time, there weren’t any cases in which a decision about the denial of coverage ought to have been made by someone trained as a physician, as opposed to some other licensed professional,” Jones told CNN. Jones said his expectation would be “that physicians would be reviewing treatment authorization requests,” and that it’s troubling that “during the entire course of time he was employed at Aetna, he never once looked at patients’ medical records himself.” Jay Ken Iinuma, who served as medical director for Aetna for Southern California from March 2012 to February 2015, according to the insurer.ĭuring the deposition, the doctor said he was following Aetna’s training, in which nurses reviewed records and made recommendations to him.
The California probe centers on a deposition by Dr. California insurance commissioner Dave Jones launched the investigation after being contacted by CNN.
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