On March 13, Aetna announced that it would not finalize its proposed settlement of In re Aetna UCR Litigation, a class action proceeding in the District of New Jersey that focused on Aetna’s use of a database of “usual and customary” reimbursement rates that plaintiffs alleged had improperly lowered member reimbursements for out of network claims. The private action followed an earlier New York Attorney General investigation into the manner in which Ingenix, at the time a data collection subsidiary of UnitedHealth, calculated usual and customary rates for several insurers, including Aetna. The New York Attorney General ultimately contended that the database had unfairly reduced reimbursements to insureds, leading to settlement with over a dozen health insurers that had used the database. UnitedHealth, Ingenix’s parent company, ultimately paid $350 million to resolve the matter. 

The In re Aetna UCR Litigation focused solely on Aetna’s potential private-party liability for its use of the Ingenix database. After several years of litigation, Aetna announced that it was settling the case in December of 2012 for $120 million. However, only days before the final hearing at which the settlement would be approved, Aetna backed out, announcing that the number of plaintiffs “opting out” of the proposed settlement exceeded the cap set forth in the parties’ settlement agreement. With the settlement terminated, the litigation now resumes in the New Jersey District Court before Judge Katherine S. Hayden.