Settlements by two insurance companies in the RICO lawsuit could have an major impact on psychiatry practices.
Try saying managed care and racketeering in the same sentence. Feels good, doesn't it?
In May 2000 the entire class of 950,000 U.S. physicians sued 10 managed care companies under the RICO (Racketeer Influenced Corrupt Organizations) Act, accusing them of conspiracy, racketeering and fraud. These 10 companies--Aetna; Anthem; CIGNA; Coventry; HealthNet; Humana; Prudential PacifiCare; United and Wellpoint--represent 90% of the managed care industry. Subsequently, over 60 Blue Cross companies have been sued in a separate action. Rather than face RICO charges in court, Aetna and CIGNA have settled.
Make no mistake: This suit and these settlements represent a huge victory for us. For the first time, we have been able to fight back against the egregious incursions of managed care into the practice of medicine. We have struck a huge blow that helps us protect our patients and our ability to give them the care they need.
What do these settlements mean to us as practicing psychiatrists?
Forty medical societies are party to the settlement, including four psychiatric societies: American Association of Practicing Psychiatrists, American Psychoanalytic Association, Massachusetts Psychiatric Society and the Psychiatric Society of Delaware. These four societies have stepped forward to work closely with the RICO attorneys to make certain that they understand how managed care tactics have harmed psychiatrists in their efforts to deliver quality care to their patients.
Your share of the $30 million fund could be as low as $40. However, you can make a difference:
Now the ball really is in our court, and it is up to each of us not to drop it. We have the tools we need to protect our patients--but we must use them. We have established a major beachhead. Now the real battle begins.