Aetna has prohibited Houston members from receiving Airrosti therapy (rapid recovery therapy) on a self-pay basis for the past two months.
Airrosti was an Aetna participating provider. Airrosti physicians perform their services within primary care physician’s offices here in Houston. The problem began when Aetna and Airrosti entered in contract
Negotiations two months ago. Aetna threatened their PCP'S with contract violation and possible contract termination if their Houston members
Received Airrosti therapy on site. As such, Houston Aetna patients couldn't receive Airrosti therapy on a cash or out-of-network basis.
Aetna's legal department recently ruled that members could receive Airrosti services on a self-pay or out-of network basis. Such services
Would be process under Airrosti separate tax ID. Aetna's recent communication
To their PCP's reiterated the risk of contract violation and termination if PCP's violate their fiduciary responsibilities to Aetna by referring
To out-of-network providers.
It is illegal for a health care provider to limit access to medical services for their members on a self-pay basis. Aetna commands approximately 30% of the Houston patient population.
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