BETHESDA, Md., Dec. 17 /PRNewswire/ -- The American Podiatric Medical Association (APMA) announced that CIGNA Healthcare has agreed with APMA and other specialty health care provider plaintiffs to settle a national class action lawsuit, pending approval by Judge Federico Moreno of the US District Court for the Southern District of Florida. The agreement ends years of dispute over CIGNA billing policies.
“We believe this agreement will benefit podiatric physicians now and in the future,” said APMA President Lloyd S. Smith, DPM. “We will continue to vigorously pursue comparable litigation against other health insurers to protect and further the interests of our members. By agreeing to this settlement, CIGNA has made improvements in its provider relations and the quality of care for its beneficiaries; we hope to reach similar agreements with other insurance companies.”
Dr. Smith continued: “APMA’s Board of Trustees, staff, and members need to be congratulated on their hard work, which brought about this settlement. In particular, I want to thank Trustees Michael J. King, DPM, chair of APMA’s Health Systems Committee, and Ross E. Taubman, DPM, chair of APMA’s Health Policy Committee, for their devoted work in initiating, facilitating, and resolving this lawsuit.”
The settlement includes significant changes in CIGNA payment policies as well as $11.55 million in direct payments to class members, including podiatrists and all other non-MD and non-DO health professionals. The class includes health care professionals who provided services during a period of nearly 15 years to patients insured by CIGNA and other managed care companies named in the suit. As part of the settlement, CIGNA will make its claims editing process more transparent, reducing confusion and disagreement over payments to podiatric physicians and other health care providers. Practitioners will have many more tools to understand and, if necessary, challenge CIGNA payment decisions. CIGNA will make crucial information available online, implement independent external review to resolve billing disputes, and create a specialty provider advisory committee, including a podiatric physician representative, to improve communication between CIGNA and practitioners. The reduced administrative burden on practicing podiatrists is worth millions of dollars indirectly to APMA members. CIGNA currently covers medical costs for more than 13 million people with plans in all 50 states.
APMA, the California Podiatric Medical Association, the Florida Podiatric Medical Association, the Texas Podiatric Medical Association, Scott J. Ashton, DPM, and Robert Vranes, DPM, brought suit against CIGNA on behalf of themselves and/or their members, claiming that CIGNA improperly denied, delayed, and diminished payments for health care services provided to beneficiaries. Eventually, several lawsuits were combined into a single nationwide class action to be litigated in Miami. The class action followed the path taken by MDs and DOs in their own managed care litigation. The MDs and DOs have settled with CIGNA and Aetna.
Founded in 1912, the American Podiatric Medical Association is the nation’s leading professional society for foot and ankle specialists. The association has component societies in 53 locations in the U.S. and its territories and a membership of more than 12,000 doctors of podiatric medicine. For free foot health information, contact the APMA at 1-800-FOOTCARE (1-800-366-8227) or visit http://www.apma.org/ on the Web.
Available Topic Expert(s): For information on the listed expert(s), click appropriate link. Dr. Lloyd S. Smith http://www.profnet.com/ud_public.jsp?userid=499858
American Podiatric Medical Association
CONTACT: George Tzamaras of American Podiatric Medical Association,+1-301-581-9220, or gptzamaras@apma.org
Web site: http://www.apma.org/
