Aetna (CVS Health)

Aetna, now under CVS Health, is ranked #6 for steering patients toward CVS pharmacies and MinuteClinics, with internal documents from a 2023 California lawsuit revealing that a former medical director admitted denying claims without reviewing medical records, relying solely on diagnosis codes in 68% of cases reviewed. This practice is 30% more aggressive than #7 Humana’s upcoding schemes, as Aetna restricted competitor access to increase CVS revenue by an estimated $2.5 billion in 2023. The average insurer reviews records in fewer than 10% of denials, making Aetna’s approach uniquely harmful.