LAWFUEL – The Law News Network – On July 11, 2005, counsel for approximately 900,000 physicians and WellPoint, Inc., announced that they have settled two national class actions pending in federal court for the Southern District of Florida before U.S. District Judge Federico Moreno as well as multiple state court actions filed against the company. WellPoint is the fourth company named as a Defendant in the Managed Care Litigation in Florida to settle with physicians. The agreement includes the resolution of two national lawsuits against both pre-merger companies, WellPoint Health Networks Inc. and Anthem, Inc. (“WellPoint”) and includes substantial commitments by WellPoint to institute a significant number of business practice changes that will benefit physicians.
This agreement includes industry-leading improvements to physician-related business practices. The cornerstone of these business practices is WellPoint’s agreement to apply generally accepted medical standards. Additionally, WellPoint has committed to increase transparency in paying claims and has agreed to an enforcement mechanism to help ensure compliance with the terms of the settlement. The business practice changes and transparency add significant value to physicians in terms of ensuring reduced overhead and greater focus on patient care. The agreement will also streamline communication between physicians and WellPoint, reduce administrative complexity in the claims payment system and help to improve the quality of the health care system in general.
If approved by the court, the agreement would conclude this lawsuit against WellPoint as part of on-going multi-district litigation currently pending against many of the nation’s largest for-profit health insurers and which is scheduled for trial on January 23, 2006.
The settlement also includes a payment of $135 million to a settlement fund for payments to physicians and $5 million to a non-profit foundation devoted to better health care. The total value of the business practice changes is hundreds of millions of dollars.