Search research articles

ABOUT JoVE

Overview Leadership Blog JoVE Help Center

AUTHORS

Publishing Process Editorial Board Scope & Policies Peer Review FAQ Submit

LIBRARIANS

Testimonials Subscriptions Access Resources Library Advisory Board FAQ

RESEARCH

JoVE Journal Methods Collections JoVE Encyclopedia of Experiments Archive

EDUCATION

JoVE Core JoVE Business JoVE Science Education JoVE Lab Manual Faculty Resource Center Faculty Site

Terms & Conditions of Use

Related Concept Videos

Standards of Care I

Standards of Care I

Federal statutes profoundly impact nursing practice, providing critical guidelines to ensure patient care is equitable, accessible, and of the highest quality. The following laws address distinct aspects of healthcare provision and patient rights:

Standards of Care II

Standards of Care II

Nurses bear specific legal responsibilities under several federal statutes, including:

Aneurysm III: Interprofessional Care

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...

Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists

Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists

Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme (ECE). Of...

Cardiopulmonary Resuscitation III: AED Use

Cardiopulmonary Resuscitation III: AED Use

Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...

Nurses' Legal Responsibilities III

Nurses' Legal Responsibilities III

Nurse-to-nurse relationships are legally required to adhere to professional standards, ensuring a respectful and positive working environment. Professional conduct demands that nurses treat all colleagues respectfully and courteously, fostering a productive, supportive workplace. Nurses must actively eliminate bullying, discrimination, and harassment to maintain a safe and inclusive environment.
Cultivating a culture of collaboration and mutual respect among nurses transcends mere enhancement...

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by

Same author

Insurers, behave yourselves: TMA pushes national code of conduct.

Texas medicine·2014

Same author

TMA practice consulting will change you for the better.

Texas medicine·2014

Same author

Saving lives through education.

Texas medicine·2014

Same author

Real meaningful use.

Texas medicine·2013

Same author

Part of the team.

Texas medicine·2013

Same author

Big decision.

Texas medicine·2013

Same journal

Commentary: This Is Not a Drill.

Texas medicine·2021

Same journal

Healthy Determination: Texas Physicians are Finding Better Ways to Address Their Patients' Social Determinants of Health.

Texas medicine·2021

Same journal

Going Local: Accountable Health Organizations Could Help Combat Social Disparities at the Local Level.

Texas medicine·2021

Same journal

Data Driven: Medicaid's Inspector General Focuses on Fraud Prevention, Not Just Prosecution.

Texas medicine·2021

Same journal

Talk to Patients About: Vaccine Adverse Event Reporting System (VAERS).

Texas medicine·2021

Same journal

Obstacles to Clear.

Texas medicine·2021

See all related articles

Search research articles

Related Experiment Video

Updated: May 13, 2026

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

Aetna to pay up.

|March 13, 2013

Summary

This summary is machine-generated.

Aetna will pay $120 million to physicians and patients following a lawsuit alleging the insurer used flawed Ingenix databases to underpay for out-of-network services. This settlement addresses concerns over inaccurate usual, customary, and reasonable (UCR) rate calculations.

More Related Videos

Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma

Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma

Published on: November 4, 2010

Cooling or Warming the Esophagus to Reduce Esophageal Injury During Left Atrial Ablation in the Treatment of Atrial Fibrillation

Cooling or Warming the Esophagus to Reduce Esophageal Injury During Left Atrial Ablation in the Treatment of Atrial Fibrillation

Published on: March 15, 2020

Related Experiment Videos

Last Updated: May 13, 2026

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma

Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma

Published on: November 4, 2010

Cooling or Warming the Esophagus to Reduce Esophageal Injury During Left Atrial Ablation in the Treatment of Atrial Fibrillation

Cooling or Warming the Esophagus to Reduce Esophageal Injury During Left Atrial Ablation in the Treatment of Atrial Fibrillation

Published on: March 15, 2020

Area of Science:

Health Insurance Law
Medical Economics
Healthcare Policy

Background:

Insurers have historically used databases to determine out-of-network reimbursement rates.
Ingenix, a subsidiary of UnitedHealthcare, provided databases for setting usual, customary, and reasonable (UCR) rates.
Concerns have been raised about the accuracy and fairness of these databases.

Purpose of the Study:

To report on the Aetna settlement regarding the use of Ingenix databases.
To highlight the legal challenges and allegations surrounding UCR rate determination.
To inform stakeholders about the financial and operational implications for insurers and providers.

Main Methods:

The study is based on a settlement following a 2009 lawsuit.
Legal allegations centered on the use of Ingenix databases by Aetna.
The settlement involved a payment of $120 million.

Main Results:

Aetna agreed to a $120 million settlement payment.
The settlement resolves allegations that Ingenix databases deflated payments for out-of-network services.
The lawsuit was brought by multiple medical associations and societies.

Conclusions:

The use of flawed databases like Ingenix can lead to significant financial penalties for insurers.
This case underscores the importance of accurate and transparent methods for determining physician reimbursement.
The settlement may influence future practices in setting out-of-network payment rates.