The Agreement includes procedural changes, called "business practice initiatives," that are intended to improve physician-company relations going forward. Some of these initiatives had already been implemented while the parties were discussing settlement. The initiatives include greater automation by Aetna of claims handling to reduce the average time for payment of "clean claims," increased use of the Internet to enable physicians to conduct certain Aetna business transactions electronically, publication of Aetna fee schedules for certain CPT codes on an annual basis, reduced pre-certification requirements for certain procedures, 90 days' notice of changes in Aetna policies and procedures, and disclosure of payment rules. The settlement also defines "medically necessary" for use in Aetna agreements in physician-oriented terms, as "health care services that a physician, exercising prudent clinical judgment, would provide to a patient."