Federal Court Approves Agreement Between Aetna And Dentists
HARTFORD, Conn., July 23, 2004 — A U.S. Federal Court late yesterday gave final approval to an agreement between Aetna (NYSE: ΑET) and representatives of nearly 150,000 dentists and the American Dental Association (ADA). The goal of the agreement is to improve communications and collaboration and to lessen complexity in the payment of dental claims.
"We are gratified by the Court’s action, which allows Aetna to move forward in making meaningful changes to the way we interact with dentists," said John W. Rowe, M.D., Aetna chairman and CEO. "The dental community and Aetna share the common goal of finding new ways to work cooperatively to achieve better dental health for our patients and members. By setting out specific business-practice initiatives and new levels of transparency in our relations with dentists, Aetna is moving forward with the goal of being a leader in creating a more efficient health care system and forging stronger ties to health care professionals."
"The ADA is extremely pleased with the Court’s decision," said Dr. Eugene Sekiguchi, President of the American Dental Association. "The terms of the settlement agreement are unprecedented in the insurance industry and will significantly strengthen the relationship between dentists and their patients. The ADA looks forward to a new level of cooperation between Aetna and organized dentistry, which will greatly benefit people who are enrolled in Aetna dental plans."
The agreement approved by the Court settles a national dental class action that had been consolidated with a series of similar actions brought on behalf of physicians. The agreement with dentists follows a settlement of the physician cases announced on May 22, 2003, and given final approval on October 24, 2003.
Aetna has agreed to pay $4 million to dentists and $1 million to the ADA Foundation. The costs associated with this agreement were anticipated and already recorded in the second quarter of 2003, as part of the charge associated with Aetna’s settlement of the Physician Class Action Litigation.
Among the specific actions contained in the agreement are:
Establishing a Dental Advisory Committee to provide advice to Aetna on issues of concern to dentists.
A commitment to timely processing of "clean" claims.
Initiatives to reduce claims resubmissions.
Disclosure of claims-editing policies, procedures and practices.
Increased electronic connectivity, and direct web-enabled access to Aetna systems to verify reimbursement information and track claims.
The $1 million contribution to the ADA Foundation will support initiatives to enhance dental health care for Americans.
The not-for-profit American Dental Association (ADA ) is the nation’s largest dental association, representing more than 149,000 members. The premier source of oral health information, the ADA has advocated for the public’s health, and promoted the art and science of dentistry since 1859. The ADA’s state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of Acceptance long has been a valuable and respected guide to consumer and professional products. For more information about the ADA, visit the Association’s web site at www.ada.org
The ADA Foundation is the charitable arm of the American Dental Association, and is dedicated to improving health and making lives better, one person at a time. Since 1991, the ADA Foundation has disbursed more than $11 million to support such charitable activities.
As one of the nation’s leading providers of health care, dental, pharmacy, group life, disability and long-term care benefits, Aetna puts information and helpful resources to work for its approximately 13.3 million medical members, 11.2 million dental members, 8.1 million pharmacy members and 12.4 million group insurance members to help them make better informed decisions about their health care and protect their finances against health-related risks. Aetna provides easy access to cost effective health care through a nationwide network of more than 618,000 health care professionals, including over 370,000 primary care and specialist doctors and 3,783 hospitals. For more information, please visit www.aetna.com. (Figures as of March 31, 2004)