Doctors, MCOs Battle Over Class Action Suit
Lawyers representing physicians from Texas, California and Georgia who have accused eight managed care companies of "conspir[ing] to fraudulently deny reimbursements for medical expenses" yesterday asked a federal judge in Miami to consolidate the similar claims of 600,000 doctors nationwide as a single class-action suit, saying it is the most "efficien[t]" way to address the complaints, the Dallas Morning News reports. However, attorneys for the insurers -- including Aetna Inc., Cigna Corp., Humana Inc., Foundation Health Systems Inc., PacifiCare Health Systems, United Healthcare and Wellpoint Health Networks -- argued that the payment methods used by the companies were too disparate to be handled in a single suit (Curriden/Conklin, Dallas Morning News, 5/8). Plaintiffs' lawyer Harley Tropin said, "The only meaningful way to address it is through a nationwide remedy. A busy doctor cannot carry on one of these litigations against" the insurers (McNair, Miami Herald, 5/8). Joe Whatley, another attorney for the physicians, said, "Since [the insurers] steal a little bit of money from a lot of people, there's no way this case can proceed claim by claim or individual by individual" (AP/Tampa Tribune, 5/8). But Richard Doren, a lawyer for Aetna, said that each insurer has thousands of reimbursement rates and that the disputed claims can be covered by up to 50 state laws (Reuters/New York Times, 5/8). Brain Boyle, an attorney for Humana, added, "I think trying to resolve this case on a class-action basis would be mind-numbing. There's no need to try to stage a gargantuan, epic trial trying to resolve every physician grievance ever uttered." The case was heard by U.S. District Court Judge Federico Moreno, who "isn't expected to rule on the class-action request for months." In addition to the physicians' case, consumers have filed a "parallel lawsuit" against managed care companies and are also seeking class-action status (Miami Herald, 5/8).