Aetna Case Summary

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associated compensation schedules (it does not), Aetna has failed to pay a number of the Hospitals’ charges for implants that meet Aetna’s own definition of “implantable device.”
28. The Hospitals therefore request that the Arbitrator compel Aetna to adhere to the NUBC’s definition of “Other Implants” and its agreement to compensate the Hospitals for items billed in accordance with that definition “in addition to other negotiated rates.”
IV. CLAIMS FOR RELIEF
Cause 1 – Breach of Contract
29. The Hospitals incorporate and re-allege paragraphs 1-23.
30. As alleged above, Aetna agreed, in the GC Agreement and its associated Compensation Schedules and the TOH Agreement and its associated Compensation Schedules, to compensate the GC Hospitals

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