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https://www.mrllp.com/blog-jury-awards-aetna-37-4m-in-medical-billing-fraud-case
Bay Area Surgical Management LLC, et al., 1-12-CV-217943 (Superior Court of Santa Clara County), unanimously awarded Aetna Inc. over $37.4 million in damages, finding that a network of surgical centers overbilled Aetna, Inc. for out-of-network procedures by, among other things, recruiting patients by approving waivers of co-pays and other fees. Those co-pays and fees, however, were not …
https://www.healthcarefinancenews.com/news/aetna-awarded-374-million-lawsuit-against-bay-area-surgical-management
Apr 22, 2016 · Health insurance giant Aetna has declared victory in a years-old lawsuit against Bay Area Surgical Management, after a civil jury slapped the California medical group with a $37.4 million dollar judgement, Aetna said. The verdict, which was handed down late last week, followed an almost-month long trial.
https://www.kriegdevault.com/blog/994-aetna-claims-victory-four-year-old-lawsuit-against-bay-area-surgical-management
Jun 08, 2016 · Aetna has recently filed two lawsuits resembling this action against physician-owned surgery centers in Texas and Pennsylvania. The case caption is: Aetna Life Insurance Co. v. Bay Area Surgical Management LLC et al., 1:12-cv-217943, in the …
https://www.leagle.com/decision/infdco20160719749
Jul 18, 2016 · The following factual allegations are taken from Plaintiffs' FAC. Plaintiff Bay Area Surgical Management, LLC manages ambulatory surgical centers, including some owned and operated by the other Plaintiffs. FAC ¶ 3. The remaining six Plaintiffs own and operate ambulatory surgery centers at which outpatient surgeries are performed. Id. ¶¶ 4-9. Defendant Aetna is a health insurance company …
http://lawzilla.com/blog/aetna-life-insurance-company-inc-v-bay-area-surgical-management-llc-3/
Case Name: Aetna Life Insurance Company, Inc. v. Bay Area Surgical Management, LLC, et al. Case No.: 1-12-CV-217943 There are several motions currently before the Court. Defendants Bay Area Surgical Management, LLC, Bay Area Surgical Group, Inc., Forest Ambulatory Surgical Associates, L.P., SOAR Surgery Center, LLC, Knowles Surgery Center, LLC, National Ambulatory Surgery …
https://www.lexology.com/library/detail.aspx
Apr 19, 2016 · On April 13, 2016, a jury in Santa Clara, California awarded Aetna, Inc. $37.4 million from Bay Area Surgical Management, LLC (“BASM”), six of its affiliated surgery centers …Author: Carol K. Lucas
http://lawzilla.com/blog/aetna-life-insurance-company-inc-v-bay-area-surgical-management-llc/
According to the allegations of the First Amended Cross-Complaint (“FACC”), cross-defendants Aetna Health of California, Inc., Aetna Life Insurance Company, and Aetna Health Management, LLC (collectively, “Cross-Defendants”) advertise and sell health insurance policies to individuals by representing to them that they can obtain healthcare from any physician of their choice, including out …
https://www.law360.com/cases/5515bda2adb7ae3510000006
Aetna, UnitedHealth Dodge Surgery Centers' Antitrust Suit. A California federal judge on Monday tossed an antirust suit brought by several ambulatory surgery centers against Aetna Life Insurance Co., a unit of UnitedHealth Group and others over an alleged "group boycott" of their services, ruling that plaintiffs failed to prove the defendants formed a conspiracy.
https://www.thehealthlawfirm.com/blog/posts/aetna-wins-374-million-verdict-in-case-against-fraudulent-overbillings-and-payment-of-kickbacks.html
Apr 20, 2016 · The victory for Aetna ends a month long trial and four years of litigation against a total of ten defendants. Included in the list of defendants were the centers, Bay Area Surgical Management LLC and the organization’s three co-founders.
https://www.leagle.com/decision/infdco20130226a44
On February 2, 2012, Aetna sued a group of San Francisco bay area surgical centers and individual defendants (collectively "defendants") in state court for fraudulently securing payments from Aetna for services rendered to members of its health plans.
https://www.beckersasc.com/asc-coding-billing-and-collections/california-jury-awards-aetna-37-4m-in-asc-billing-fraud-scheme-6-key-notes.html
Bay Area Surgical Management also failed to disclose the physicians' financial interest in the referral base, which led to Aetna's fraud claim. The surgical management company allegedly charged more than seven-times what other clinics charged for the same procedure.
https://www.thefocalpoint.com/cases/198
Aetna brought suit on behalf of its insureds against BASM, its officers, and its facilities to recover the overpayments in full and put an end to Defendants’ exploitation of the health care system. The Focal Point’s Role. The Focal Point was retained to provide and graphics and trial presentation services for Gibson Dunn and co-counsel.
https://www.law360.com/articles/849196/medical-group-must-face-insurers-after-37m-loss-to-aetna
The case is Bay Area Surgical Management LLC et al. v. Lloyd’s London et al., case number 2014-1-CV-271552, in the Superior Court of the State of California, County of Santa Clara.
https://gibsondunn.com/wp-content/uploads/documents/publications/GDC-Top-Verdicts-Aetna-DJ-2-15-2017.pdf
Aetna Life Insurance Co. v. Bay Area Surgical Management LLC A etna sued a group of San Francisco Bay Area surgery centers for over-charges submitted through a sophis - ticated scheme of insurance fraud. Plain-tiffs’ lawyers said it is a fraudulent business model that is increasingly common across the country, involving in-network providers
https://www.aetna.com/individuals-families/using-your-aetna-benefits/network-out-of-network-care.html
It includes doctors, specialists, dentists, hospitals, surgical centers and other facilities. These health care providers have a contract with us. As part of the contract, they provide services to our members at a certain rate. This rate is usually much lower than what they would charge if you were not an Aetna …
https://www.buchalter.com/publication/aetna-vs-basm-pigs-get-fat-and-hogs-get-slaughtered/
On April 13, 2016, a jury in Santa Clara, California awarded Aetna, Inc. $37.4 million from Bay Area Surgical Management, LLC (“BASM”), six of its affiliated surgery centers and its three principals.
Bay Area Surgical Management (BASM) is one of the largest and fastest growing ambulatory surgery center providers in the San Francisco Bay Area. BASM, its 100+ award-winning physician-partners and our highly skilled team of nurses and health care professionals are dedicated to ensuring that our patients receive world-class care in a comfortable ...
https://www.gibsondunn.com/lawyer/liversidge-samuel/
Representation of Aetna in Bay Area Surgical Management et al. v. Aetna Life Insurance Company et al. (Norther District of California), where plaintiffs brought antitrust claims alleging an unlawful conspiracy to retrain trade in the healthcare market. The case was successfully settled following the court’s grant of defendants’ motion to dismiss.
https://revcycleintelligence.com/news/aetna-awarded-37.4-million-in-healthcare-fraud-lawsuit
Aetna Awarded $37.4 Million in Healthcare Fraud Lawsuit Aetna is the victor in a $37.4 million healthcare fraud lawsuit against Bay Area Surgical Management, which was accused of …
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