Supreme Court Declines To Hear Insurer Appeal in Class-Action Suit Filed by Doctors
The Supreme Court on Monday declined to hear an appeal filed by six health insurers in a bid to stop a class-action lawsuit brought by more than 600,000 doctors who claim the companies underpaid them for treating patients, Bloomberg/Hartford Courant reports (Bloomberg/Hartford Courant, 1/11). In the lawsuit, the physicians allege that Humana Health Plan, PacifiCare Health Systems, UnitedHealthcare, WellPoint Health Networks, Anthem Blue Cross and Blue Shield and Health Net delayed or denied reimbursements for health services and illegally rejected claims for necessary medical treatments as part of a racketeering conspiracy. Aetna and Cigna, which also were named as defendants in the lawsuit, have settled with the physicians for a total of $1.01 billion. In September 2004, a three-judge panel of the 11th Circuit U.S. Court of Appeals in Atlanta upheld class-action status for the suit (California Healthline, 1/3).
The Supreme Court's decision allows the lower court's ruling to stand, meaning that the class-action suit will proceed in federal court in Miami (AP/Seattle Post-Intelligencer, 1/10). The move "places heavy pressure" on the insurers to settle and not "roll the dice and possibly incur potentially crippling, even bankrupting damages awards," according to the Blue Cross and Blue Shield Association, which is facing similar lawsuits that could be affected by legal precedents set in this case. However, Kent Jarrell, a spokesperson for the insurance companies, said, "We remain confident of prevailing because of the evidence we will present at trial."
Archie Lamb, co-lead counsel for the doctors, said the ruling was "the final nail in [the] coffin" for the insurers' argument that the case should not have class-action status. Lawyers for the doctors said they plan to seek billions of dollars in damages when the case returns to the Miami court in September (Bloomberg/Hartford Courant, 1/11).