■ Tun Association of New Jersey Chi-ropractors (ANJC), one of the largest chiropractic state associations in the nation, recently announced that it has filed a lawsuit against Aetna, seeking nationwide relief on behalf of chiropractors and other healthcare professionals. The ANJC retained the law firm of Buttaci & Leardi, LLC, in concert with the renowned class action law firm of Pomerantz Haudek Grossman & Gross LLP, to investigate and file the lawsuit, which challenges Aetna's improper recoupment demands on chiropractors and other healthcare providers. The action alleges that Aetna's post-payment audit process is violative of the Employee Retirement Income Security Act of 1974 ("ERISA"), and further alleges that Aetna's post-payment audit process and its pre-payment claim review process violate the Racketeer Influenced and Corrupt Organizations Act ("RICO"). The action also attacks Aetna's clinical policy bulletins that are used to deny services retroactively. The suit has been filed as a class action on behalf of all healthcare provid- ers nationwide who have been harmed by Aetna's conduct. The ANJC has joined the action in a representational capacity on behalf of its members. The Complaint seeks: (1) to stop Aetna from continuing to engage in impermissible audit and recovery practices; (2) to stop Aetna from enforcing clinical policies that are substantively baseless; (3) compensation for chiropractors who have been coerced into making payments to resolve or defend against Aetna's unlawful overpayment actions; and (4) compensation for chiropractic trade associations, like the ANJC, who have devoted significant time and resources dealing with these various improprieties. Counsel for plaintiffs are continuing to investigate these claims, and other related claims that may be added to the litigation. If you have any questions, please contact Dr. Sigmund Miller, executive director for the Association of New Jersey Chiropractors by email-ing [email protected] or calling 1-908-722-5678.
