Aetna faces $4.5 million fine for violating insurance laws in Missouri
Missouri Governor Jay Nixon has announced that health insurance provider Aetna will be paying $4.5 million in fees for violating state law. One of these violations has to do with Aetna covering elective abortions even though some policies did not allow for such coverage. This represents the single largest insurance penalty imposed against a company in Missouri’s history. Notably, the health insurance company is holding itself accountable for any violations of state law, also acknowledging that it had violated a 2010 law concerning coverage for autism treatments.
Company has run afoul of regulations concerning autism coverage and coverage for elective abortions
Aetna had notified its policyholders concerning the availability of autism insurance and that such coverage is optional. The company did not require members to accept or deny additional coverage, however, which ended in some policyholders paying more for their policies than they had realized. The company is now reviewing claims from those that were affected by this issue and will be paying for claims that were incorrectly denied as a result.
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Aetna has been hit by fines for violating state law before
In 2012, the health insurance provider was fined $1.5 million for similar violations of state law regarding autism, elective abortions, and contraceptive care. Since that time, Aetna has reported that it has covered nine elective abortions for women with additional health insurance coverage, despite the fact that the company agreed that it would no longer do so after it was fined. The company also failed to completely audit its compliance with state laws.
Aetna may lose the ability to do business in Missouri if it does not comply with state law
The health insurance company could face a three-year monitoring period imposed by the state’s Department of Insurance. If the company continues to violate state laws, the agency can stop the company from doing business in Missouri for up to a year. If the company does comply with state laws to a sufficient degree, the Missouri Department of Insurance may waive $1.5 million of the $4.5 million fee imposed upon the company.