Class action suits-at last!

After years of steadily decreasing reimbursement, refusal to authorize payment for most specialty services at all, and frequently late payment for preauthorized services, insurers for medical care have exceeded the tolerance of even the most ataractic physicians. Doctors have had the choice of agreeing to unfair take-it-or-leave-it contracts with flagitious insurance companies, or of no longer treating their patients who have insurance with these companies. A nationwide effort by state medical associations to file class action lawsuits against the major offending insurance companies is now under way.

On March 4, 2001, I attended the American Academy of Otolaryngology--Head and Neck Surgery Board of Governors Legislative Representative Committee Meeting in Washington, DC, as a Governor representing the Los Angeles Society of Otolaryngology. At that meeting, the class action lawsuits filed by the Connecticut State Medical Society against the state's six largest health plans were discussed, and members from all states were urged to encourage their own states to join with Connecticut at no charge.

The California Medical Association (CMA) in May 2000 filed a federal lawsuit against Blue Cross of California, PacifiCare Health Systems, and Foundation Health Systems under federal Racketeer Influenced and Corrupt Organizations (RICO) Act laws. It charged the plans with unfair contracting, unnecessarily denying and delaying payment to physicians for procedures patients need, and reimbursing physicians at rates insufficient to cover costs. The CMA later joined the national class action suit that named eight for-profit plans as defendants.

The United States Congress has been unwilling to pass meaningful corrective legislation required to protect the well-being of our patients. Hopefully, this judicial effort will provide a remedy.

JACK L. PULEC

Editor-in-Chief

EAR, NOSE & THROAT JOURNAL