Health care insurer Aetna is on the legal and PR defensive following a report that some called “shocking.”
California’s insurance commissioner, Dave Jones, launched an investigation into Aetna’s practices and protocols after its former medical director admitted under oath that he didn’t view patient files when approving or denying claims.
CNN first broke the story, reporting the following exchange from the deposition of Dr. Jay Ken Iinuma, Aetna’s medical director for Southern California from March 2012 to February 2015:
Iinuma said he never looked at a patient’s medical records while at Aetna. He says that was Aetna protocol and that he based his decision off “pertinent information” provided to him by a nurse.
“Did you ever look at medical records?” Scott Glovsky, Washington’s attorney, asked Iinuma in the deposition.
“No, I did not,” the doctor says, shaking his head.
“So as part of your custom and practice in making decisions, you would rely on what the nurse had prepared for you?” Glovsky asks.