UnitedHealth Wins Battle In Managed Care Suit

The 11th Circuit does not conduct the same analysis of how the “plus factors” provision of antitrust law applies to Racketeering Influenced and Corrupt Organization cases, but “even if that requirement is not applicable, the district court’s judgment is still due to be affirmed under the facts and circumstances of this case,” the court writes.

The 11th Circuit appellate court has jurisdiction over Alabama, Florida and Georgia.

At press time, the defendants were not immediately available to comment, and it was not clear whether the plaintiffs would appeal the 11th Circuit ruling.

If the ruling stands, and UnitedHealth does not negotiate the kind of settlement agreement its competitors have negotiated, the company will not be subject to the kinds of settlement agreement provisions that will regulate many competitors’ dealings with physicians. Typical managed care litigation settlement agreement provisions require that competitors publish detailed contract and pricing information on their physician Web sites.

“We are pleased that this decision puts the Shane vs. Humana class action claims behind us,” Thomas Strickland, UnitedHealth’s chief legal officer, says in a statement about the 11th Circuit ruling. “This ruling affirms the Southern District Court of Florida’s finding in support of our position that there was no evidence of improper conduct by UnitedHealth Group.”

The company “looks forward to continuing to work collegially with physicians and their professional organizations to improve the quality of care delivery and to simplify health care administration,” Strickland says.