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CALIFORNIA / News and Insight on Business in the Golden
State

Psychologists Sue Aetna, Claim Denial of Services

September 29, 1998|DAVAN MAHARAJ | TIMES STAFF WRITER

A group representing 5,000 psychologists in California sued Aetna U.S. Healthcare on Monday, claiming the health maintenance organization routinely denies mental health services to patients in order to boost profits.

The suit by the California Psychological Assn. seeks to prevent Aetna from "falsely advertising prompt, accessible mental health services" to lure patients to its health plan.

John E. McDermott, an attorney for the psychologists, said the HMO's advertisements promise to provide 20 to 50 outpatient visits per year with a psychologist, yet the company limits such visits to four or five.

Psychologists who seek additional sessions for their patients are dropped from the provider network, the suit alleges.

"Their theory is the lesser the benefit they provide the more money they make," McDermott said.

The suit accuses Aetna of false advertising and unlawful business practices.

An Aetna spokesman in San Francisco said company executives had not seen the suit and would not comment.

By suing Aetna, McDermott said, the psychologists are targeting a widespread practice by some HMOs.

"We want to send a message that if you play these games, we're out there looking at you," he said. "We're going after what is widely regarded as the worst HMO in the state to force them to change their practices."

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