Humana Reaches Settlement in Class-Action Lawsuit Filed by 700,000 Physicians Nationwide
Kentucky-based Humana has reached a settlement in a class-action lawsuit filed on behalf of more than 700,000 physicians nationwide, the AP/Wall Street Journal reports (AP/Wall Street Journal, 10/19). In the lawsuit, physicians allege that Aetna, Anthem Blue Cross and Blue Shield, Cigna, Coventry Health Care, Health Net, Humana, PacifiCare Health Systems, Prudential Financial Securities, United Healthcare and WellPoint Health Networks delayed or denied reimbursements for medical services and illegally rejected claims for necessary services as part of a racketeering conspiracy.
Aetna and Cigna have settled with the physicians for a combined $1.01 billion. Health Net and Prudential Financial Services, which Aetna purchased in 1999, have settled for a combined $167 million. WellPoint and Anthem, which merged late last year, also have reached tentative settlements (California Healthline, 9/28).
In the latest settlement, Humana has agreed to pay $40 million and as much as $18 million in legal fees for the plaintiffs. The settlement requires approval by U.S. District Judge Federico Moreno in Miami (Baltimore Sun, 10/19).
The settlement recognizes that Humana has invested more than $75 million to improve the speed and accuracy of its claims process. "Humana is pleased that we have been able to reach an agreement to settle this litigation," company CEO Michael McCallister said. The three companies that remain in the lawsuit -- UnitedHealth, Coventry and PacifiCare -- are scheduled for trial in January (AP/Wall Street Journal, 10/19).