Miami, FL --- CIGNA HealthCare and representatives of over 700,000 physicians, state and other medical societies have settled a national class action pending in the federal court for the Southern District of Florida before U.S. District Judge Federico Moreno, as well as multiple state court actions filed against the company. CIGNA has agreed to resolve the massive lawsuit ending months of contentious negotiations

The sweeping document includes industry-leading improvements to physician-related business practices as well as cash payments to physicians in accordance with terms outlined within the agreement.  Finally, the settlement provides additional funding for an independent foundation dedicated to improving the quality of health care in America.  The agreement will enhance communication between physicians and CIGNA, reduce administrative complexity in the claims payment system and help improve the quality of the health care delivery system. These changes are expected to result in increased predictability and speed of claims payment, creating significant value for physicians by reducing time-consuming and costly administrative burdens and giving physicians and their office staffs more time to focus on their central mission - providing health care to patients.

The economic aspects of the settlement is multifaceted and includes a guaranteed cash payment to physicians of at least $85 million as well as an unlimited “claims made” process that is certain to yield additional financial benefits.  Also included is a $15 million payment to a Foundation focused on health care issues important to physician’s nation wide.  The value to physicians of the past and current business practice improvements and investments agreement is estimated at approximately $400 million.    The dollar value of savings to physicians due to the agreement’s removal of administrative burden could equal approximately $300 million during the term of the agreement.   The total value to physicians of today’s agreement is in excess of $700 million.   

“This landmark collaboration recognizes the importance of the physicians’ input in all healthcare decisions.  CIGNA’s agreement to be bound by these innovative industry guidelines embodied in the settlement demonstrates that only by a commitment to partnership can the true goal of quality healthcare be achieved,” noted Co-lead Counsel for the physicians, Archie Lamb.

    

Key Changes in Business Practices

The physicians and CIGNA have agreed to new levels of transparency and communication as well as a renewed commitment concerning business practices through a number of initiatives. “This is another step in the right direction.  This is clear evidence that CIGNA has a strong desire to reach out to physicians and their patients. With these settlements, CIGNA and Aetna are sending a clear signal that they are willing to structure their business practices in a way that benefits both doctors and their patients," noted Jack Lewin, M.D., CEO of the California Medical Association.

Tim Norbeck, executive director of the Connecticut State Medical Society applauded the agreement and added that “Today CIGNA should be congratulated for agreeing to a settlement that demonstrates their openness and support of physicians and their patients.  As we have continually made clear, our primary goal from the beginning has been to change the system and make it better for physicians and their patients.  Our member physicians are pleased that many of their issues have been addressed by this settlement, and we believe that these terms will in turn benefit patients as well.  By taking this significant step CIGNA joins Aetna in setting a new standard for the industry,” concluded Norbeck.

 The Medical Association of Georgia's President, Dr. Michael Greene concurred and noted "This settlement is a significant step forward for both patients and doctors.  As a family physician, I am particularly pleased that CIGNA will recognize the doctor's role in making medical decisions.” 

Dr. Bohn Allen, President of the Texas Medical Association added that “This is all about changing the way these health plans do their business. With a federal judge to enforce this agreement, physicians can take care of CIGNA patients without wondering how -- or whether -- they'll get paid.” 

"This settlement places an ailing health care system on the road to recovery through a set of commitments which are premised upon achieving the highest quality health care,” said Edith Kallas, partner with Milberg Weiss Bershad Hynes & Lerach in New York. 

                   

Medical Societies Endorse Agreement

Other medical societies and associations across the country also support the agreement.  Donald J. Palmisano, MD, JD, President, American Medical Association noted "The American Medical Association (AMA) is pleased that CIGNA and the plaintiff physicians and medical associations have agreed to resolve many of the significant problems that have plagued physicians who treat CIGNA enrollees.  CIGNA is to be commended for agreeing to change its business practices and improve its relationships with practicing physicians and their patients. We are hopeful other health insurers will follow CIGNA's example and work cooperatively with physicians on behalf of patients.  The AMA will continue to support physicians across the country to resolve these important issues with health insurers."  The agreement has been endorsed by medical societies and professional organizations nation wide and each will be actively encouraging their members to indicate their support for the proposal.