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Aetna overstated spending on patient-care category

Wall Street Journal, December 9, 2009

Aetna Inc. spent less money on patient care for some small businesses than it originally reported in regulatory filings, according to a Senate committee scrutinizing insurers' profits as Congress pushes to overhaul the healthcare system. The Senate Committee on Commerce, Science and Transportation launched an investigation last summer into the percentage of premiums insurers spend on medical care versus profits and other administrative expenses. In a statement, the committee said Aetna overstated by $4.9 billion the amount of money it spent on patient care for small businesses. As a result, the insurer's medical-loss ratio for small businesses was 79%, not the 82% Aetna initially reported, it said.