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February 24, 2015 at 10:58 AM
The U.S. Supreme Court is skipping over an appeal from physicians who want to be able to sue Anthem Inc. (NYSE:ANTM) over how Anthem units calculate “usual, customary and reasonable” rates for out-of-network services.
Many of the physicians in the case, Medical Association of Georgia et al. vs. WellPoint Inc. (Case Number 14-554), were involved in efforts to get Anthem, which was previously known was WellPoint, to agree to a 2005 settlement in connection with reimbursement practices. The plaintiffs involved in that class action agreed to release the company from claims “in any way related” to the facts in exchange for $450 million in cash payments and investments in changes in business practices.
Anthem has argued that the settlement agreement should keep the class members from taking further action.
The physicians say that they should be able to proceed with claims involving reimbursement decisions and other antitrust-related actions that took place after 2005, and that letting the 2005 settlement agreement block suits over post-2005 problems would be wrong.
