HMO Silence on Pay Deals Upheld

Aetna Inc., Kaiser Permanente and other managed-care companies don’t have an obligation to reveal details of their doctor-reimbursement policies to consumers, an appeals court ruled Tuesday in a setback for consumers who have filed a wave of lawsuits alleging the industry is considering costs when making certain medical decisions.

The U.S. 5th Circuit Court of Appeals upheld a federal judge’s dismissal of consumer lawsuits against Aetna, Kaiser, Cigna Corp. and other health-maintenance organizations. The suits alleged that the companies violated federal law by not disclosing financial agreements with doctors who make treatment decisions.

Consumer and plaintiffs’ lawyers have filed a number of lawsuits seeking to recover millions for consumers who allegedly were denied adequate medical treatment by doctors receiving bonuses for rationing health care.

“It is for Congress to determine whether to impose such a duty to disclose . . . and this court will not encroach on that authority by imposing a duty Congress has not chosen to impose,” the New Orleans-based appeals court said.