It also forced patients to endure weeks of pain and physical therapy on broken bones and undergo repeated and unnecessary physician visits in attempts to secure necessary medical care. Without timely diagnosis, patients were at risk that life threating conditions would go untreated. The pre-authorization reviews run by AIM Specialty Health were alleged to deny the sophisticated imaging and other medical tests patients needed to detect and diagnose cancer and other deadly conditions. The qui tam whistleblower complaint alleged that AIM Specialty Health wrongly denied requests from treating physicians to pre-authorize MRI, CT, cardiac stress tests, sleep studies and other high tech diagnostic tests for seniors, people with disabilities, and others with Medicare Advantage insurance plans. Chicago, Illinois - AIM Specialty Health, Inc., a subsidiary of Anthem, Inc., that manages radiology and other benefits for Medicare Advantage insurance plans nationwide has agreed to pay $13 million plus fees to settle a whistleblower lawsuit filed in the United States District Court for the Northern District of Illinois by Hughes Socol Piers Resnick and Dym, Ltd.(HSPRD) and litigated along with Phillips & Cohen LLP.
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