CMA Settles Class-Action Lawsuit With Anthem/Wellpoint - 07/11/05

Article from the California Medical Association Online


In a defining moment in their nationwide racketeering case against HMOs, the California Medical Association and more than a dozen other state medical associations representing more than 800,000 physicians agreed today to a settlement with Wellpoint/Anthem, the largest remaining health plan defendant in a class action lawsuit in U.S. District Court in Miami. The settlement provides $135 million in direct payments to physicians resolving allegations of unfair reimbursement for more than a decade by Wellpoint/Anthem, the largest for-profit health insurer in California. U.S. District Judge Federico Moreno must approve the settlement. The agreement also mandates dramatic changes in Wellpoint/Anthem’s heavy-handed business practices, which will result in prospective relief worth more than $250 million to physicians and their patients...“This agreement recognizes a very basic principle: that the physicians’ input is paramount and not to be second-guessed by corporate executives. The Wellpoint/Anthem agreement to implement innovative industry guidelines means that patients will get the quality care they deserve,” noted CMA President-elect Anmol Mahal, M.D. “It is a shame that other health plans are still delaying doing what is right for patients.”