Health Insurer AETNA Files Lawsuit Against Medical Provider for Alleged Fraudulent Billing
Newark, NJ – Aetna Life Insurance Company has initiated legal proceedings against Maximum Medical & Rehabilitation, LLC, and its associated entities, alleging a pattern of fraudulent billing practices that resulted in substantial financial losses for the insurance provider. The lawsuit, filed in the U.S. District Court for the District of New Jersey, outlines a detailed complaint accusing the defendants of systematically overcharging and submitting false claims for services rendered to Aetna beneficiaries.
The complaint, officially docketed as Case No. 2:24-cv-10362, was publicly released by GovInfo.gov on September 3, 2025. Aetna asserts that Maximum Medical & Rehabilitation engaged in deceptive conduct designed to defraud the insurance company and, by extension, its policyholders. Specific allegations include claims of billing for services that were not performed, upcoding procedures to inflate costs, and submitting claims for medically unnecessary treatments.
According to the lawsuit, Aetna conducted an internal review that uncovered discrepancies and questionable billing patterns originating from Maximum Medical & Rehabilitation. These findings, the company states, form the basis of their legal action to recover improperly paid claims and to prevent future fraudulent activities.
The legal filing represents a significant step in the ongoing efforts by healthcare payers to combat what they describe as pervasive healthcare fraud. Such litigation often highlights the complex interplay between healthcare providers, insurers, and the intricate billing and coding systems that govern medical reimbursements.
Aetna’s lawsuit seeks to recover the alleged overpayments, along with damages and legal costs associated with the investigation and prosecution of this case. The outcome of this litigation could have implications for how medical providers are scrutinized for billing practices and for the ongoing efforts to ensure the integrity of the healthcare payment system.
At this stage, the defendants have not yet filed a formal response to the allegations outlined in the complaint. The case is now proceeding through the court system, where evidence will be presented and legal arguments will be made. Further developments in this case will be closely watched within the healthcare and legal communities.
24-10362 – AETNA LIFE INSURANCE COMPANY v. MAXIMUM MEDICAL & REHABILITATION et al
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