HMO Ordered to Cover Claims in Texas, Louisiana, Oklahoma
The Louisiana Supreme Court on April 1 ordered health maintenance organization Health Net Inc. to cover more than $180 million in claims by consumers, health care providers and creditors in Louisiana, Oklahoma and Texas.
Health Net sold health plans in the three states to AmCareco Inc. in 1999. In 2002, the troubled health plans were placed under state supervision. Each of the state’s insurance departments sued AmCareco and Health Net, alleging fraud, negligence, conspiracy and breach of fiduciary duty.
In 2005, a state district court jury awarded the Texas plaintiffs around $100 million in damages. In 2005, a state judge in Baton Rouge issued similar verdicts against Health Net and awarded $30 million to the Louisiana and Oklahoma plaintiffs.
The Supreme Court reversed a state appeals court decision that threw out those verdicts.