Judge OK's HMO Settlements With Doctors

Sep 28, 2005 6:48 am US/Central



MIAMI (AP) A federal judge has approved an estimated $167 million in settlements by two managed health care companies in a massive class action lawsuit by hundreds of thousands of doctors.



U.S. District Court Judge Federico Moreno on Monday signed off on the settlements reached by Health Net Inc. and Prudential Financial Services with about 950,000 doctors nationwide.



The settlements bring the number of agreements approved by Moreno to four in the class action lawsuit by doctors and medical societies against 10 of the nation's largest HMOs.



Under the settlement, Health Net will pay $40 million to active and retired doctors. It will also spend an estimated $80 million to improve its processing of doctors' bill submissions.



Prudential will pay $22.2 million to improve managed care and will ensure that other companies follow through on their settlements.



Health Net will pay $20 million in doctors' attorney fees, and Prudential will pay $5 million.



WellPoint Health Networks Inc. and Anthem Inc., have also reached tentative settlements.



Since the legal actions began in 2000 Prudential has been sold to Aetna and Anthem has merged with WellPoint.



"These latest settlements are significant in the changes that will be made in the treatment and payment to doctors similar to those agreed to by CIGNA and Aetna," said Harley Tropin, a lead attorney for the doctors.



Tropin said the trial is scheduled in January for the four remaining management companies, Coventry Health Care Inc., UnitedHealth Group Inc., Humana Inc. and Pacificare Health Systems Inc., but negotiations to reach settlements are ongoing.



Suits against the 10 HMOs were combined into a single class action lawsuit and assigned by a panel of federal judges to Moreno.