Profession

HMO class action suit another step closer to trial

NEWS IN BRIEF — Posted Dec. 6, 2004

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Doctors suing the nation's HMOs don't need to arbitrate their claims against the companies, the 11th U.S. Circuit Court of Appeals ruled in November. The court, upholding a lower court ruling, said arbitration clauses in some physicians' contracts can't be used to force doctors to arbitrate disputes they never agreed to arbitrate.

The managed care companies being sued had argued that the lawsuits against them should not be allowed to go forward as a class action and instead physicians with arbitration agreements in their contracts should have to arbitrate with the companies.

The appellate court decision likely will mean the doctors' lawsuits, which have been combined before one judge, will go ahead on schedule, said Archie Lamb, co-lead counsel of the national class action lawsuit. A trial is scheduled in a federal court in Miami for March 2005.

Physicians and organized medicine filed lawsuits against the largest health plans claiming that the companies, among other things, paid doctors unfairly.

Aetna and CIGNA have reached settlement agreements with the doctors. The November ruling applies to the remaining defendants in the case.

Those defendants are Pacificare Health Systems, Humana, Coventry Health Care, Anthem Health Plans, Prudential Insurance Co. of America, United Healthcare, United Health Group, Human Health Plan and WellPoint Health Networks.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2004/12/06/prbf1206.htm.

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