Profession

Federal judge gives final approval to WellPoint settlement

Four unresolved cases between physicians and insurers regarding underpayment of claims head for an April trial.

By Amy Lynn Sorrel — Posted Jan. 30, 2006

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A U.S. District Court judge gave the final stamp of approval to a $198 million settlement agreement between WellPoint and more than 700,000 physicians who are part of a national class-action lawsuit that accused the company of unfairly underpaying insurance claims.

Medical societies and doctors' attorneys in the case hailed the settlement, reached in July 2005, as a positive step toward better cooperation in the health care system. Doctors also said it would allow them to focus more on patient care.

Judge Federico A. Moreno, of the Southern District of Florida, Miami Division, approved a $135 million settlement fund to compensate doctors' claims, and up to $58 million in legal fees to be paid by WellPoint. The company will contribute $5 million to a nonprofit foundation that promotes higher quality health care for disadvantaged patients.

The agreement also includes changes to WellPoint's business practices so physicians can more easily resolve billing disputes and ensure timely payments.

The settlement resolved two lawsuits, one filed against WellPoint HealthNetworks and the other against Anthem. After the lawsuits were filed, the companies merged.

Under the settlement, WellPoint did not admit any wrongdoing in the matter. The final approval also resolved other lawsuits already filed against the company.

Individual doctors and medical societies sued the nation's largest insurers, accusing them of improperly paying them.

The WellPoint settlement is similar to earlier settlements with Aetna, Cigna, Prudential Insurance Co. and Health Net.

An April 17 trial date is set for cases against four remaining HMOs: Humana, Coventry, PacifiCare Health Systems and UnitedHealthcare.

More information about the WellPoint settlement is online (link).

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