RICO Case Materials
Texas BCBS Is Part of RICO Settlement
Even though it is not formally named in the notice you received, Blue Cross and Blue Shield of Texas is part of the settlement of the federal class action lawsuit against the Blue Cross system, and you can file a claim.
CIGNA Settlement Expires: Review Your Contracts
CIGNA’s 2003 settlement agreement under the national class-action antiracketeering case expired Sept. 4, ending CIGNA's obligation to comply with the terms of the settlement. Expiration of the settlement will not affect physicians who already have submitted valid claims for damages from the Claim Distribution Fund and are waiting to be paid.
Blue Cross Settlement Notices in the Mail; Claims Deadline Oct. 19
Physicians will soon begin receiving official notice of the settlement of the federal antiracketeering lawsuit against Blue Cross and Blue Shield, along with instructions on how to file a claim for past harm. Claims must be filed by Oct. 19.
Physicians Can Resubmit Previously Denied CAD Mammography Claims to CIGNA
Medical societies involved with the Physicians Advocacy Institute (PAI), physicians may resubmit their previously denied CAD mammography claims to CIGNA. This opportunity to resubmit claims is another victory resulting from the settlements in the national MDL class action lawsuits against the nation’s for-profit health plans.
Resolution of Aetna RICO Lawsuit Settlement Compliance Issues
Aetna agreed to change its business practices as part of the settlement of a federal antiracketeering lawsuit filed against the company and other for-profit HMOs by the Texas Medical Association and 18 other state medical societies. However, that was only part of the battle. Since then, attorneys for TMA and the other plaintiffs have been closely monitoring Aetna's compliance with the settlement terms. When Aetna was found to be violating the agreement, the attorneys resolved the disputes in physicians' favor. Here is a summary of the resolved settlement compliance disputes.
Plaintiffs 7, Defendants 2: Judge Dismisses Claims Against Two Defendants
This Law feature presents an update on how the defendants are complying with the settlements of organized medicine's antiracketeering lawsuit against the HMOs.
Aetna Agrees to Change Modifier 25 Policy
Texas Medical Association and other plaintiffs suing for-profit HMOs have resolved their dispute with Aetna over payment of claims with the modifier 25.
What to Expect from RICO Lawsuit Settlements
What to Expect from RICO Lawsuit Settlements
Make Sure Aetna Keeps Its Promises
Efforts by the Texas Medical Association and other plaintiffs to make sure Aetna Healthcare lives up to its promises when it settled a federal antiracketeering lawsuit two years ago have caused Aetna to acknowledge that patients are entitled to receive the care their physician deems necessary.
Prospective Relief - Fair Payment Rules
Side-by-side comparison of the billing, coding, and payment provisions of the Aetna, CIGNA, Health Net, and WellPoint/ Anthem settlements in the RICO case and existing federal law.
HMO Antiracketeering Lawsuit Settlement Enforcement Toolkit
RICO Case Settlement Toolkit - Details, explanations, and forms
Health Net and Prudential Settle RICO Suits
Health Net and Prudential Financial have agreed to settle their portions of the RICO lawsuit. Physicians have until Sept. 21, 2005, to file claims for past damages from Health Net.
Physicians and WellPoint Announce Settlement of Landmark Litigation
Physicians and Wellpoint, Former Anthem Inc. and Wellpoint Health Networks Inc. Announce Settlement of Landmark Litigation - Settlement will improve quality of health care, end administrative burden placed on physicians
TMA Enters RICO Lawsuit: Full Text of Dr. Rohack's Address
Full text of Dr. Rohack's address
Aetna Pays Physicians in RICO Lawsuit Settlement
About 950,000 physicians have received payments from Aetna under terms of the settlement of its part of a federal class-action antiracketeering lawsuit.
TMA Joins Physicians and Medical Societies Across the Nation in Federal Racketeering Lawsuit
Texas Medical Association joins physicians and medical societies across the nation in federal racketeering suit against for-profit managed care plans.
Federal Judge Certifies Physicians' Class Action Case Against HMOs
Federal Judge Certifies Physicians' Class Action Case Against HMOs