[ Friday, October 18, 2002 ]


From a Medical Newswire e-mail distribution I get:

MIAMI (Medical Newswire) The good news for health maintenance organizations is that a federal judge denied class certification status to an estimated 145 million patients in a class action suit against health plans.

The bad news is that U.S. District Judge Federico Moreno did grant class status to 600,000 doctors, and their lawyers can now group their claims into one enormous -- and extremely important -- case against HMOs.

The doctors in the suit are accusing health plans of systematically delaying and down-coding payments to providers. In his Sept. 26 decision, Moreno noted that the doctors have "done more than just allege a common scheme but ... have demonstrated facts that support its existence."

The health plans immediately appealed the decision, and the U.S. Supreme Court announced Oct. 15 that it will step in to determine whether certain doctors' cases are required to go through arbitration first, as specified in their HMO contracts. If so, the size of the class would be reduced.

Jeff [3:43 PM]

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