Settlement Between Physicians and Cigna Expected in September in Illinois Suit

Attorneys for Cigna and about 700,000 physicians on Tuesday said that by September the two sides hope to reach agreement on a revised settlement of a class-action lawsuit filed against the health insurer in Illinois, AP/Long Island Newsday reports (Wilson, AP/Long Island Newsday, 7/8). In the lawsuit, physicians allege that Cigna used a program called ClaimCheck to screen their claims for combinations of procedures and eliminated or reduced reimbursements for some of them; as a result, the physicians allege that they received less than the amount for which they billed Cigna. Cigna and attorneys for the physicians filed a settlement with a federal judge in Illinois. Under the settlement, Cigna agreed to pay back claims to 600,000 to 700,000 physicians and other health care providers. However, a federal judiciary panel in February ordered that Federico Moreno, a U.S. district judge in Miami, rule on the proposed settlement; Moreno over the past three years has overseen a separate national class-action lawsuit filed against Cigna and several other health insurers. The Miami lawsuit alleges that Cigna, Aetna, United Healthcare, Coventry Health Care, WellPoint Health Networks, Humana Health Plan, PacifiCare Health Systems and Anthem BlueCross BlueShield delayed or denied reimbursements for health services and rejected claims for medically necessary treatments as part of a racketeering conspiracy. Attorneys for Cigna and the physicians entered mediation to discuss a revised settlement of the Illinois lawsuit in April (California Healthline, 3/31).

Timeline

Attorneys on both sides said that they expect to have a settlement to present to their clients in two weeks; Cigna attorneys did not comment on the terms of the settlement (Hartford Courant, 7/9). Archie Lamb, an attorney for the physicians, said, "There are still substantive provisions to be worked out." Moreno tentatively set a Sept. 4 hearing for preliminary approval of the settlement (AP/Long Island Newsday, 7/8).

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