even if a "filed insurance rate doctrine" were to be recognized.
Aetna started it. Aetna sued Insys. Aetna alleged that Insys defrauded Aetna into reimbursing Insys and its officers for off-label prescriptions of a certain drug.
MSI tried to join the party. Specifically, MSI tried to intervene in Aetna's lawsuit against Insys. Its motion for leave to intervene was ultimately denied, but the Court's treatment of the filed rate doctrine raised by Aetna is worth noting.
MSI alleged that it is Aetna's insured, and that it, MSI, purchased healthcare coverage for its employees from Aetna. MSI alleged against Insys that Insys's alleged misconduct caused MSI to pay increased premiums, higher deductibles, and pay greater co-pays charged by Aetna than otherwise would have been the case without Insys's alleged misconduct.
Aetna did not want MSI at Aetna's party. Aetna opposed MSI's intervention in part by raising the filed rate doctrine. Aetna contended that its rates "are filed with and approved by the Pennsylvania Insurance Department," so that the Court did not have jurisdiction to adjudicate MSI's claims which challenged Aetna's filed insurance rates, Aetna contended.
This Court would have none of that. The Federal Judge ruled that "this doctrine is a defense to claims rather than a jurisdictional bar." Aetna Inc. v. Insys Therapeutics, Inc., 330 F.R.D. 427 (E.D. Pa. 2019) (pinpoint page numbers not available from Westlaw at the time of publication).
Simple as that. No ruling whether Pennsylvania would recognize a filed insurance rate doctrine or not, and no need to rule on that question. Instead, the filed rate doctrine as the Court recognized in this case is a defense on the merits, not a defense to jurisdiction.
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