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Judge asked to let 37 million patients sue their HMOs

Gunning for the nation's top HMOs, the lawyer who won a 1997 epic settlement from Big Tobacco has asked a Miami federal judge to let 37 million consumers nationwide sue six HMOs for alleged fraudulent business practices.

"These problems are systemic within each insurer and between each insurer."

Attorney Richard Scruggs appeared before United States District Judge Federico Moreno on July 24, 2001, to ask that members of Aetna, CIGNA, HealthNet, Humana, Prudential, and UnitedHealthcare be allowed to band together in a class action to sue their HMOs for concealing deceptive business practices, such as offering incentives to doctors to limit patients' medical care.

According to Barry Meadow, an attorney working on the case with Scruggs and David Boies, Al Gore's chief litigator in the 2000 Florida presidential vote recount, the consumers' request to certify the lawsuit as a class action makes sense given the widespread problems in the managed care industry. Meadow charges that "these problems are systemic within each insurer and between each insurer."

The consumers allege that their insurers systematically reduce, delay, and deny payments and reimbursements to them by hiding certain business practices, such as offering bonuses to doctors who don't refer patients for more extensive testing and treatments.

Aetna attorney Richard Doren argued that the case should not be allowed to go forward as a single class action because the number of consumers is too great and there is too much variety between their many health plans. Meadow, however, contends that the consumers could indeed be separated into groups within the class action and that it would be impossible for each consumer to file a separate lawsuit.

Miami courtroom is a stage

The fate of how health insurers will be able to conduct their business in the future is being played out in Moreno's courtroom. A separate set of lawsuits grouping 600,000 doctors against the managed care industry is currently on hold, pending appeals by the health insurance industry.

On May 9, 2001, Moreno ordered full discovery in the lawsuit brought by doctors, a ruling that requires each party to request information and documents from the other side in an attempt to "discover" facts relevant to the case. At the time of Moreno's discovery ruling, Rocky Wilcox, the general counsel for the Texas Medical Association, promised the order "will rip back the curtain and expose to the American public all the dirty tricks these HMOs play every day."

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