By Bob Fernandez From The Philadelphia Inquirer Aetna hired nurse Carol Wessner as a quality management consultant in Philadelphia in 2013 as the health insurer was expanding to cover almost 100,000 low-income Pennsylvania children under Medicaid. Wessner had a simple task: figure out why many children under Aetna’s coverage weren’t being screened for their health. What she discovered over the next three years disturbed her. On paper Aetna looked as if it operated a robust physician network for the kids. But the reality was that among those listed to care for them were doctors who had died, moved out of state, or didn’t specialize in pediatrics, Wessner concluded. Some providers had no contract with Aetna. “Tens of thousands of children” were assigned to care providers that had no relationship with Aetna, Wessner claims in a federal whistleblower lawsuit filed in 2017 and recently unsealed in the Pittsburgh federal court. Pennsylvania …
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