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Monday, February 22, 2010

HUMANA WILL CONTINUE TO HONOR KEY TERMS OF RICO LAWSUIT SETTLEMENT

Organized medicine’s settlement agreement with Humana in our class action antiracketeering lawsuit expired late last year, but the company has voluntarily agreed to maintain many of the most important terms of the agreement. Humana will continue to honor important new coding rules, the clinical definition of medical necessity, and the 18-month limit on seeking recovery for overpayments. TMA entered the lawsuits against the country’s largest for-profit health plans in 2001. Blue Cross and Blue Shield, CIGNA, Health Net Inc., Prudential Insurance Company of America, Anthem Inc./WellPoint, and Humana all agreed to settlements with the medical societies.

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