TMA's Legal Action Against Health Care Payment Plans

Keywords: Court_Cases  Managed_Care  RICO  

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With more than 900,000 physicians represented by medical groups, including state and county medical societies, the lawsuit filed under Racketeer Influenced and Corrupt Organization Act (RICO) against for-profit health plans is the largest class-action health care lawsuit filed in the United States. The lawsuit actually is a consolidated series of suits that began in Alabama in 1999, when a physician sued Humana, CIGNA, and several other HMOs. The doctor alleged that health insurers used fraudulent marketing tactics and financial incentives to restrict patient care, thereby breaching their obligations under federal law to provide necessary medical care. Within a year, a score of other suits making similar allegations were filed on behalf of patients and physicians.

In March, 2001, TMA entered the lawsuit by filing claims against CIGNA and Humana, two of the largest for-profit health plans in Texas. TMA joined the California Medical Association, the Medical Association of Georgia, the Denton County Medical Society, and 20 individual physician plaintiffs who had filed federal lawsuits across the country against other for-profit plans. After all lawsuits were consolidated under a single federal judge in Miami, Aetna was the first of the HMOs to settle. Since then, CIGNA, Health Net, Prudential, WellPoint [Unicare], and Humana have also settled. Claims against UnitedHealth Group Inc. and Coventry Health Care Inc, the final defendants in the RICO lawsuit, were dismissed by U.S. District Judge Federico A. Moreno in Miami. An appeal is pending.

Read the Compliance Dispute Resolution report (PDF) produced by Deborah Wineguard summarizing the compliance actions against Aetna and CIGNA. TMA has also prepared the latest report of the RICO settlement at-a-glance.

In a separate action, a settlement has been reached with BlueCross BlueShield of Texas and 90 percent of the Blue Cross Blue Shield plans across the country.

For information go to the HMO Settlements Web site, www.hmosettlements.com. This site serves as a source for information about the settlements reached between representatives of over 900,000 physicians, state and county medical societies with Aetna, Blue Cross Blue Shield, CIGNA, Health Net Inc., Prudential Insurance Company of America, Anthem Inc./WellPoint, and Humana Inc. 


Specific HMO Settlement Information

Blue Cross and Blue Shield

CIGNA

Aetna Settlement
Humana

WellPoint/Anthem Settlement (Blue Cross of California)
Health Net Settlement
Physicians' Foundations

The Physicians’ Foundations were established as the result of a settlement entered into by representatives and certain medical societies with Aetna and CIGNA in the In re Managed Care Litigation. For more information go to www.physiciansfoundation.org.

Links to Additional Resources

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Last Published: 6/23/2008

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RICO Case Materials

TMA, TMLT Battle Wyeth in U.S. Supreme Court

The quality of patient care could be compromised and physicians would risk more liability lawsuits if the U.S. Supreme Court sides with the drug manufacturer Wyeth in a Vermont case. That is the conclusion reached in a brief filed with the court by TMA, the Texas Medical Liability Trust, and the North Carolina Medical Society.


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


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