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Federal Court Dismisses CMA’s RICO Lawsuit Against Pacificare
A federal court this week dismissed CMA’s RICO lawsuit against Pacificare. In a summary judgment, U.S. District Judge Federico Moreno ruled that CMA and the other plaintiffs had not presented sufficient evidence that Pacificare had conspired to underpay physicians. This ruling does not affect the cases pending against the remaining defendants, United Healthcare and Coventry. In the ruling, Judge Moreno noted that Pacificare is in a different situation than the other defendants in the case because it does the vast majority of its managed care business through capitation with IPAs, which were not parties to the case. Seven of the 10 HMO defendants have already settled with CMA and the other plaintiffs in the case, including more than a dozen other state medical societies and more than 900,000 physicians and their beneficiaries. CMA is extremely disappointed by this ruling and will vigorously pursue the case against the two remaining defendants, United Healthcare and Coventry. CMA is also considering an appeal of the Pacificare ruling. Contact: CMA’s legal information line, 415/882-5144 or legalinfo@cmanet.org
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