A large group of insurers has won a class-action suit alleging that it was delaying and denying payments inappropriately. Plaintiffs in the massive suit--which included not only more than a dozen individual physicians, but also the California Medical Association, Texas Medical Association, Medical Association of George, Florida Medical Association and Louisiana State Medical Society--had claimed that a group of plans used claims processing software to delay, cut back and refuse payment of their fees.
This week, however, a U.S. district judge upheld an earlier ruling that there was not enough evidence that insurers underpaid physicians. The appeals judge dismissed all remaining claims. The decision should take a weight off of the shoulders of many health plans targeted by the suit, which included Coventry Health Care, Health Net, Pacificare Health Systems, Prudential, United Health Group, WellPoint and Anthem.
To find out more about the suit:
- read this St. Paul Business Journal item
- read the amended class action complaint (.pdf)