Medical Records Not Reviewed By Medical Director Before Claim Denied

Forbes is reporting on a story first appearing on CNN,  where the Former Aetna Medical Director Admits To Never Reviewing Medical Records Before Denying Care.

“This admission was made during a deposition in a lawsuit brought against Aetna by [a patient]… with common variable immune deficiency (CVID) who was denied coverage for an infusion of intravenous immunoglobulin (IVIG) four years ago.”  The former medical director testified that the process was for nurses to review records and then make recommendations to him.  Additionally, “when asked by Washington’s attorney if it was his general practice to look at medical records as part of his decision making process, he replied that it was not.”

Thanks to Julie Kitzmiller for alerting me to the story.