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Aetna files federal complaint against Laboratory Corporation of America

by Astrid Fiano, DOTmed News Writer | August 31, 2010
Legal action
over information use
Aetna Inc., Aetna Health Management, LLC, and Aetna Health Holdings LLC (collectively, Aetna) have filed a federal lawsuit in the Eastern District of Pennsylvania accusing Laboratory Corporation of America Holdings (LabCorp) of misusing confidential information in order to continue receiving referrals from Aetna physician providers. Aetna is headquartered in Blue Bell, Pa., and Hartford, Conn. LabCorp is located in Burlington, N.C.

According to the complaint, LabCorp's activities in allegedly misrepresenting its status resulted in Aetna members' lab tests being sent to LabCorp, and costing Aetna more money than if the tests had been sent to Aetna's current in-network provider.

The complaint states that from the late 1990s to 2007, Aetna had services agreements with LabCorp, with specific provisions not to use the confidential information obtained through the services, including member and provider data. Aetna alleges that LabCorp learned the identity and characteristics of the network providers, which members used LabCorp services, and that Aetna participating physicians used the networks to maximize members' benefits and provide utilization review and quality management.

Aetna terminated the services agreement in 2007. LabCorp then allegedly sent letters to providers saying that Aetna had terminated the contract, but that LabCorp services would not cost more than in-network providers. Aetna says that LabCorp at first reduced its charges but gradually escalated the charges, resulting in higher costs to Aetna. Aetna also alleges that LabCorp's later communications gave the false impression to providers and members either that members would continue to receive LabCorp services at an in-network cost, or that LabCorp was still an in-service provider. Based on the misleading communications, Aetna says that physicians referred services to LabCorp instead of Aetna's in-network providers.

Aetna is requesting that LabCorp be prohibited from using Aetna's trade secrets, as well as monetary damages.