200,000 Physicians: Cigna Settlement Bad for Doctors and their Patients.

Business Editors/Legal Writers

NEW ORLEANS--(BUSINESS WIRE)--Dec. 10, 2002

Medical societies from 19 different states today condemned as woefully inadequate a proposed settlement in a lawsuit involving Cigna Health Care. The proposed settlement in the Kaiser vs. Cigna case would bar almost all of the managed care claims against Cigna pending in a class action case being heard by U.S. District Judge Federico Moreno in Miami and in other state court actions.

"The terms of this settlement are a giant step backward compared to the HMO reforms we can win through the anti-racketeering lawsuit that now represents a certified class of all of the nation's treating doctors and other significant state court actions," said Donald Timmerman, MD, representing Connecticut physicians. "This settlement, if allowed to stand, could significantly erode our ability to combat the abuses of the profit-driven managed care industry."

The medical societies that today said they oppose the Cigna settlement represent more than 200,000 physicians across the country. They include state medical societies from: Texas, California, New York, Florida, Connecticut, Georgia, New Jersey, Tennessee, South Carolina, New Hampshire, Arizona, Louisiana, Alaska, Maine, Nebraska, North Carolina, and Hawaii; and county medical societies from Colorado, Virginia, and Texas.

A number of these medical associations and their physician members have been involved in state and federal court litigation for more than three years in an effort to remedy the ongoing burden U.S. doctors face each day as they try to deliver appropriate and high quality medical care to their patients. Defendants in that case include Cigna, Aetna, United HealthCare, Humana, and other large, managed care companies. That case has recently been certified as a class action representing the nation's doctors.

In an attempt to avoid the class action suit, Cigna has engaged in a complex and questionable series of procedural maneuvers to settle a separate suit. That proposed settlement would bar almost all of the claims pending in the class action case being heard by U.S. District Judge Federico Moreno in Miami and other state court actions.

"An important part of what we're fighting for is a long-term and significant change in the way these companies do business with the American people and their doctors," said Fred Merian, MD, president of Texas Medical Association. "The Cigna settlement comes up short in many ways."

For example, under the proposed settlement, Cigna would still be able to use financial criteria to overturn the decisions of the treating physician when it comes to determining whether a given course of treatment is medically necessary for a patient. It also allows Cigna to continue some of its most onerous restrictions on how physicians practice medicine, as long as the company discloses those restrictions publicly.

"Basically, they can still have their way with us, they just have to tell us what they're going to do ahead of time," said Jack Lewin, MD, of the California Medical Association.

Physicians in the class action case have asked Judge Moreno to block the Cigna settlement. The judge is expected to rule on that request by Dec. 13, 2002.