Supreme Court Rules RICO Suit May Proceed to Trial
[Posted 06/16/05]

In a victory for the nation’s physicians and patients, the U.S. Supreme Court has cleared the way for CMA’s lawsuit to proceed to trial against some of the nation’s largest for-profit HMOs. The lawsuit, originally filed by CMA on behalf of the nation’s doctors in May 2000, alleges that the for-profit HMO defendants violated federal racketeering laws by using coercive, unfair and fraudulent means to control physician-patient relationships.

The health plan defendants submitted a petition to the high court, asking that a ruling by the 11th District Court of Appeals in Atlanta be overturned. The appellate court in September 2004 upheld the trial court decision, ruling that physicians could sue HMOs for damages under the federal Racketeering Influenced and Corrupt Organizations (RICO) Act.

Although settlements have already been reached with four of the defendants—Aetna, CIGNA, Health Net, and Prudential—the high court’s action allows the case against the remaining six HMO’s to proceed to trial. The trial date has been set for September.

Contact: CMA’s legal information line, 415/882-5144 or legalinfo@cmanet.org.