Unmasking a Healthcare Scandal: Aetna vs. Radiology Partners 💼⚖️ & Savvy Imaging Choices! 🏥💡

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Aetna's lawsuit against Radiology Partners sheds light on excessive billing practices in the medical imaging industry, revealing the importance of choosing independent clinics for better pricing and quality. This episode explores the implications for patients and encourages informed choices in their healthcare decisions. 
• Aetna's legal action against Radiology Partners for fraudulent billing practices 
• Exploration of the historical context of Radiology Partners' operations 
• The financial impact on consumers and the importance of independent imaging centers 
• Recommendations for choosing where to get medical imaging 
• Insight into healthcare transparency and the need for consumer advocacy

Music by Alex Lambert.

Contact Justin via text 740-525-5259 or via email [e-mail]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits.

Episode Transcript

Speaker 1 (00:01):
Welcome to another Tuesday Morning with Justin.
I'm Justin Futrell, benefitAdvisor at True North.
Today, I want to dive into ahalf headline and the other half
a question from a listener.
So the headline is Aetna suesradiology partners over billing

(00:22):
shenanigans in Florida partnersover billing shenanigans in
Florida.
So what's going on?
There's an Aetna.
Aetna filed a lawsuit againstradiology partners, alleging
that radiology partnersimplemented a fraudulent scheme
that has inflated the cost oftheir services in Florida by
tens of millions of dollars bytens of millions of dollars.

(00:50):
In other words, after severalyears, aetna finally figured out
that they sent millions ofdollars in excess billing to
radiology partners.
How did it happen?
Well, radiology partnersstarted figuring out who had the
best contracts with Aetna andstarted acquiring them and then
getting the other providers tomove over to that contract
financial arbitrage, if you will.

(01:12):
Now, in 2022, aetna terminatedthat contract, so radiology
partners can no longer do that.
And there's all of this legalback and forth.
Blah, blah, blah.
It seems like RadiologyPartners has a way out because
of the new no Surprises Act.

(01:32):
But the importance of this iswell, how did this happen?
That's my first question.
How did this happen?
That's my first question.
How did this happen, and if yougo back to 2014,.
Radiology Partners wasdescribed as a new image of
healthcare, working to transformradiology by partnering with a

(01:55):
national network of radiologyexperts and applying a modern
tech stack to streamlineoperations and improve care.
Sounds great, pretty nicevision, but in the end,
radiology partners tookadvantage of negotiated rates
and contracts and how they couldmaximize their profitability.

(02:18):
So it leaves me with thequestion from a listener coming
to the forefront of my mind, andthat is like if I need imaging
a very practical question if Ineed medical imaging, where
should I go?
And the answer to that is findan independent medical imaging

(02:42):
center near you.
How do you do that?
Well, one of the best examplesis Green Imaging.
They have clinics across theentire country.
I think they even have 35 inRhode Island last time I checked
.
So there's a good chance thereis one near you.
Why would you go to anindependent medical imaging

(03:03):
clinic?
Well, gang, if you think aboutit, it doesn't matter whether an
MRI machine is at this smallgreen imaging clinic or whether
it's inside the four walls ofthe nicest hospital you've ever
walked into.
The MRI machine isaccomplishing the same thing, is

(03:29):
accomplishing the same thing,unless it's extremely antiquated
equipment.
There's no reason that youshould step inside the four
walls of a hospital or somethingthat's owned by a hospital, or
else you're instantly going tobe paying more money out of your
own pocket.
But this leads us to aninteresting thought and it takes
me back to a client I wasreviewing recently, before we

(03:50):
took them over as a client.
Their average MRI cost was$3,300 for the entire year, like
700 people enrolled on theirplan.
$3,300 on average plan.
$3,300 on average.
Okay, I didn't go to a greenimaging, but a similar

(04:10):
independent clinic in a monthago for an MRI.
It was $680.
$680 compared to $3,300, whichmakes me wonder, and I'd love to
hear your feedback If youremployer, if your company,
offered to give you a freemedical imaging, a free MRI, if

(04:30):
you went to one of a handful ofplaces, would you go or would
you continue to go wherever theemergency room recommended you
to?
That's probably within ahospital system.
I think this is one way.
I know that this is one way wecan impact change and drive

(04:52):
waste out of our healthcaresystem.