MEDICAL ASSOCIATIONS SUE HMOS
Two Texas medical associations and dozens of individual physicians filed a federal lawsuit last week accusing health care insurers of fraud, racketeering and conspiracy, according to a report by the Dallas Morning News. The suit, filed by the Texas Medical Association, the Denton County Medical Society and dozens of individual doctors, claim several of the nation’s largest insurers have systematically refused to pay for medical treatments deemed necessary by doctors.
The groups filed the class-action lawsuit seeking to reduce the role health maintenance organizations play in the relationship between doctors and patients. Cigna Corp., Humana Inc., Aetna Inc., PacifiCare Health Systems, Prudential Insurance Co., United Health Group and Wellpoint Health Networks are named as defendants in the suit.
“This is a huge lawsuit with historic potential,” Frank Newton, dean of the Texas Tech School of Law, was quoted in the report. “The impact of this case is right there with tobacco, maybe even bigger because it impacts so many more people.” The allegations of Texas physicians are combined with similar legal complaints filed by California and Georgia doctors in one 80-page lawsuit filed in federal court in Miami. The case will be handled by the judge overseeing the class-action lawsuit filed last year by patients against the HMOs.
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