Doctors in Suit Against Managed Care Companies Can Gather Evidence

A federal judge in Miami told attorneys for physicians alleging that eight managed care organizations engaged in racketeering by improperly delaying and denying reimbursements that they may proceed with the discovery phase of the trial, Bloomberg/Arizona Daily Star reports. The lawyers are seeking to collect evidence showing that hundreds of physician claims should be consolidated in a single class-action suit. The ruling by U.S. District Court Judge Federico Moreno, dated Tuesday, will allow the physicians' attorneys to subpoena and issue depositions to the insurers' executives (Bloomberg/Arizona Daily Star, 5/10). The ruling also compels the defendants -- Aetna Inc., Cigna Corp., Humana Inc., Foundation Health Systems Inc., PacifiCare Health Systems, Prudential Insurance Co. of America, UnitedHealth Group Inc. and Wellpoint Health Networks -- to release internal documents relating to their claims approval processes. Archie Lamb, an attorney for the physicians, said, "This decision forces the HMOs to give us the evidence we need to prove our case, to prove what we are saying is true, and to show that this case needs to proceed forward to trial as a class-action lawsuit." A spokesperson for Aetna, however, said that the company was "confident that the process will demonstrate that the lawsuits have no merit and that the physicians' claims should be handled on a claim-by-claim basis" (Curriden/Conklin, Dallas Morning News, 5/10). Under Moreno's order, attorneys have until Dec. 14 to collect documents and until March 15 to collect evidence from "expert witnesses" (Bloomberg/Arizona Daily Star, 5/10).