Eleventh Circuit Court of Appeals Affirms Trial Court’s Approval of Landmark Aetna Lawsuit Filed by the Nation’s Doctors Against Leading HMOs

Plaintiff’s Lead Counsel Archie Lamb: Today’s Order clears the way for implementation of the many benefits to physicians and the healthcare system contained in the landmark settlement agreement. 

Monday September 27, 2004:  Atlanta, GA:  The Eleventh Circuit Court of Appeals issued an Order today affirming Judge Federico Moreno’s earlier approval of the landmark settlement agreement between the nation’s physicians and Aetna.  Today’s Order, issued without opinion, also overruled all remaining objections to the settlement.   The settlement agreement, signed in May of 2003, concluded the lawsuit against Aetna involving issues dating back to 1990 and was part of on-going multi-district litigation currently pending against many of the nation’s largest for-profit health insurers. 

The landmark settlement agreement includes industry-leading improvements to physician-related business practices that set new levels of transparency in paying claims, including a National Advisory Committee of Practicing Physicians to provide advice to Aetna on issues of importance to physicians. It also establishes an independent foundation dedicated to improving the quality of health care in America. The value to physicians of the business practice improvements over the course of the agreement is estimated at approximately $300 million.  In addition to the significant business practice commitments that create a new a standard for the industry, Aetna has agreed to pay $100 million to physicians and $20 million to a foundation established by the agreement. 

"The primary achievement of this agreement for physicians is found in the fundamental recognition by Aetna of the importance of America's physicians in the healthcare equation,” said Archie Lamb, co-lead counsel of the national class action. “Aetna's promises memorialized in the agreement to commit to external review, transparency, clearly defined coding guidelines and a meaningful enforcement mechanism are truly landmark commitments. Today’s Order clears the way for implementation of the many benefits to physicians and the healthcare system contained in the agreement,” Lamb concluded. 

Additional background information on the case can be found at: www.hmocrisis.com