Health Insurance Lawsuits Dismissed

A federal judge dismissed a lawsuit against two healthcare companies that were sued by a group of more than 600,000 doctors who said the insurers routinely denied or underpaid claims.

U.S. District Judge Federico Moreno ruled Monday that there was not sufficient evidence to support claims against UnitedHealth Group Inc. and Coventry Health Care Inc.

The companies were two of 10 managed-care companies sued by the doctors in 1999. The eight other insurers agreed to pay about $650 million in settlements, but UnitedHealth and Coventry continued to fight the claims.

The racketeering lawsuit contended that managed-care companies programmed their computers to pay for cheaper, less intensive services than those that were actually provided. The U.S. Supreme Court let stand a lower court ruling that the case could be tried as a class action involving tens of thousands of doctors, both active and retired.

The companies that settled promised that they would change procedures for reviewing and processing doctors’ claims for services.

In his opinion, Moreno said that he did not condone the insurers’ actions but that the case was “beyond the power” of his court.

“Those desiring changes in the way healthcare is provided in America must either look for remedies before Congress or allow the free market to dictate the results,” the judge wrote.

Harley Tropin, a lawyer for the plaintiffs, said he was considering filing an appeal.

Coventry and UnitedHealth expressed satisfaction with the decision.

“We were always confident in our position, and we knew the evidence did not support the plaintiffs’ claims,” Coventry attorney Robert Denham said Tuesday.

The eight companies that settled were Aetna Inc., WellPoint Inc., Cigna Corp., Humana Inc., Prudential Health Insurance, PacifiCare, Anthem and Foundation Health.

Pacificare has since been acquired by UnitedHealth, Anthem has merged with WellPoint and Foundation has combined with Health Net Inc.