Aetna Files Suit Against COVID-19 Testing Companies Alleging Fraud

Aetna filed a lawsuit against several radiology companies and clinicians, alleging that they provided unlicensed services, billed for services that were not performed, and upcoded billing to inflate charges associated with COVID-19 testing.

Source: Becker's Payer Issues | Published on November 22, 2021

Blank Covid-19 Coronavirus test on stainless steel surface table

According to the lawsuit, former physicians Eugene DeSimone and Salvatore Conte converted two radiology labs into COVID-19 testing facilities before upcoding simple tests into high-level consultations and evaluations.

The defendants allegedly then used two new companies to distribute payments, despite the fact that the duo's initial two labs were unlicensed to administer rapid COVID-19 tests.

According to the lawsuit, the defendants owe Aetna $580,000 in damages and attorney fees.

Two of the defendants' companies, Rochelle Park, New Jersey-based Open MRI and Imaging of RP Vestibular Diagnostics, had previously sued Cigna for denying claims for COVID-19 tests.
 

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