Holding Blue Cross and Other Health Plans Accountable:
What the RICO Settlements Mean to You and Your Practice
[Posted 03/30/06]

CMA and AMA are presenting two one-day seminars to educate physicians about the RICO settlements and what the settlements mean to their practices. The seminars will be Thursday, May 18, at the Los Angeles County Medical Association offices in downtown Los Angeles, and Friday, May 19, at the Alameda Contra Costa Medical Association offices in Oakland.

To date, six major health plans (Blue Cross/Anthem/Wellpoint, Aetna, Cigna, Health Net, Prudential, and Humana) have settled CMA’s RICO lawsuit, which alleges that the health plan defendants engaged in fraud and extortion by wrongfully denying payment to physicians, in violation of federal racketeering law.

Although the settlements have provided nominal cash payments to physicians, their true value lies in the prospective relief that is estimated to be worth more than $1 billion in increased revenue to physicians over the next few years.

Seminar participants will learn how to maximize their relief under the settlements by identifying inappropriate health plan business practices—including improper health plan claim denials—and holding the health plans accountable for failures to comply with the settlement terms. Under the settlements, the compliance process is overseen by a court-appointed mediator.

Registration is $49 for members, $149 for nonmembers.

Contact: Jewel Thompson, 916/444-5532 or jthompson@cmanet.org.