Psychology gains second settlement in class action lawsuit

Psychologists who provided covered services to any defendant in the case will soon have access to a settlment fund established by the court

by Legal and Regulatory Affairs Staff

September 13, 2006 — In August 2006, a federal judge in Miami gave preliminary approval to Humana’s settlement with a nationwide class of psychologists and other non-physician health care professionals. The settlement calls for Humana to implement a number of policy improvements for the benefit of the class and to pay $3.5 million toward a settlement fund.

The Humana settlement fund will be available to psychologists who — between January 1, 1990 and September 15, 2006 — provided covered services to any defendant in the case. Psychologists who never submitted claims to Humana can participate, as long as they submitted claims to other defendants in this lawsuit: Aetna, Anthem, CIGNA, United, Wellpoint, Pacificare, Prudential, Coventry and Health Net. However, larger payment shares will go to psychologists with a large volume of Humana claims.

This is the second settlement in Florida class action that the APA Practice Organization and its outside attorneys have negotiated on behalf of psychology. In this litigation, a class of nonphysician health professionals, along with the Florida Psychological Association, alleges that the managed care defendants conspired to reduce and delay provider payments in violation of federal law.

The Humana settlement will be similar to the $11.5 million CIGNA settlement from 2004 in terms of the policy changes and the process for submitting claims. However, the dollar amounts paid to eligible claimants will be smaller, in part because CIGNA has many more covered lives than Humana.

The court will decide whether to give final approval to the settlement after a “fairness hearing” scheduled for December 1, 2006. The APA Practice Organization anticipates that the time period for submitting claims to the Humana settlement fund will start soon and end on January 13, 2007. Submitting claims will be straightforward and very similar to the process involved in the CIGNA settlement. Eligible psychologists will be able to submit claims online or by mail.

When the settlement claim process is finalized and available to psychologists, we will provide much more detailed information about submitting claims and other details of the settlement in future issues of this PracticeUpdate e-newsletter, online at APApractice.org and through other sources.

In our companion case against the nation’s 70 Blue Cross Blue Shield companies, the judge recently ordered the parties to participate in mediation by mid-November. The APA Practice Organization hopes that this action will lead to the next favorable settlement for practicing psychologists.