U.S. District Judge Federico Moreno of the Federal District Court on in Miami on Monday ruled that plaintiffs' lawyers can seek damages against managed care companies in a long-running class-action lawsuit filed on behalf of 700,000 doctors.
The doctors allege that the HMOs, including UnitedHealthcare, Coventry Health Care, WellPoint, Humana Health Plan, PacifiCare Health Systems, and Anthem Blue Cross Blue Shield, all engaged in a racketeering conspiracy by delaying or denying reimbursement for health services and by illegally rejecting claims for necessary medical treatments. Last September, Moreno approved class-action status for the physicians' lawsuit against the HMOs.
Aetna and Cigna, which were originally named as defendants in the lawsuit, have agreed to settle lawsuits against them.
The HMOs had filed a motion to dismiss the doctors' claims under the Racketeering Influenced and Corrupt Organizations Act, which carries triple damage awards if claims are proved. But Moreno on Monday dismissed that motion and ruled that the California Medical Association and the Texas Medical Association, which filed the suit on behalf of the doctors, can legally ask him to require the companies to change their business practices under RICO.