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Medical Groups Sue, Say Aetna, CIGNA Shortchanged Doctors

February 11, 2009

The American Medical Association, Connecticut State Medical Society and several other state societies are suing Aetna and CIGNA, saying the companies shortchanged doctors by millions of dollars for out-of-network care.The groups filed lawsuits, proposed as class actions, in a New Jersey federal court this week seeking restitution for what they call a scheme by the insurers to maximize profits.

“We can no longer ignore improper business practices of health insurers who decide to play by their own rules without regard to patients or the legitimate costs required to care for them,” said Dr. Nancy H. Nielsen, president of the AMA.

Aetna and some other insurers have already agreed to pay millions to settle New York Attorney General Andrew Cuomo’s investigation into the same matter, but those amounts didn’t include any restitution for physicians. The money will be used to create a new database to replace the problematic one run by Ingenix, a UnitedHealth Group unit.

 

Read Article: The Hartford Courant

 

First trial dates set for FEMA trailer suits

A federal judge has scheduled the first four trials for a batch of lawsuits filed on behalf of hurricane victims who claim they were exposed to potentially toxic fumes while living in government-issued trailers.

 

An order issued Tuesday by U.S. District Judge Kurt Engelhardt says cases against Gulf Stream, Fleetwood, Forest River and Keystone RV will be the first to be tried. The federal government also is expected be a defendant in each case. The first of four trials is tentatively scheduled to start Sept. 14. The next three are scheduled to start in October, December and January.

 

Hundreds of residents of Louisiana, Mississippi, Texas and Alabama who were displaced by hurricanes Katrina and Rita in 2005 have sued the government and the companies that furnished the Federal Emergency Management Agency with tens of thousands of trailers after the storms.

 

Read Article: New Orleans Times-Picayune

 

Judge Decertifies Class Action Over Off-Label Use of Epilepsy Drug

A month before a pharmaceutical class action was set for trial, a Philadelphia judge decertified the class of users of an epilepsy and neuralgia drug seeking reimbursement from the drug’s maker after being prescribed the drug for uses not approved by federal regulators.

 

Judge Mark I. Bernstein granted a pharmaceutical company defendant’s motion for class decertification in Clark v. Pfizer Monday. The case was set to go to trial March 9.

Bernstein had previously granted class certification to the class in 2007.

 

Class representatives Gregory Clark of Philadelphia and Linda Meashey of Annville, Lebanon County, brought claims of misrepresentation, negligence, negligence per se and breach of express warranty on behalf of other users of the drug Neurontin, or the generic equivalent, gabapentin. The proposed class was made up of people prescribed the drug for medical conditions other than epilepsy and the management of pain associated with herpes zoster rash outbreaks. The plaintiffs sought a refund of all noninsured payments for the drug.

 

Read Article: Law.com

 

Judge Demands Lawyers Prove Not in Cahoots to Divide Case Fees

Attorney Jay Wingate, who specialized in representing cruise line crew members in personal injury lawsuits, walked away from a robust portfolio of liability cases a year ago after Royal Caribbean Cruise Lines accused him of bribing one of its employees.

 

Now, Wingate faces allegations that he violated a court order by conspiring with a former associate to cut themselves in for a percentage of the 77 cases he dropped.

 

Miami-Dade Circuit Judge Herbert Stettin issued a show cause order demanding Wingate, former associate Peter Sotolongo and Brett Rivkind of Rivkind Pedraza & Margulies in Miami prove they shouldn’t be held in contempt of court for violating an omnibus court order issued in January 2008 setting the ground rules for the future handling of the cases.

 

Read Article: Law.com

 

Pa. Court Rejects Challenge to Statutory Limit on Asbestos Liability

A deeply divided Superior Court en banc panel ruled asbestos plaintiffs didn’t have standing to challenge on constitutional grounds a statute limiting the liability of successor corporations in asbestos litigation.

 

A four-judge minority said denying the plaintiffs standing would treat in-state and out-of-state plaintiffs differently and argued the statute treats in-state and out-of-state companies differently.

 

Both sides agreed in Johnson v. American Standard that Philadelphia-based Crown Cork & Seal Co. did not have to pay any more in asbestos liabilities on behalf of Mundet Cork, a company it purchased in 1963, because Crown Cork already paid out millions in liabilities attached to the company. Because Crown Cork paid out in liability more than the fair market value of Mundet at the time of its purchase, the company met the cap under 15 Pa. C.S.A Section 1929.1.

 

Read Article: Law.com

 

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