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American Medical Group Association

Friday, 16 May 2008

Health Net Settlement Information

The following documents will help you understand your rights under the Health Net Settlement Agreement

Pertinent information:

Date settlement reached by parties:

May 2, 2005

Final approval date:

July 1, 2006

Value of settlements:

In excess of $140 million

Retrospective relief:

$40 million

- $39 million to Settlement Fund

- $1 million to Foundation

Prospective relief:

$80 million

Health Net Settlement Effective Date July 1, 2006
The Health Net Settlement became effective July 1, 2006. Physicians who submitted a proof of claim form to Health Net may expect payment in early 2007. We do not currently know the amount that the settlement will pay to individual class members.

Questions about the settlement may be directed to Health Net Physician Settlement Administrator at (866) 254-8048 or Whatley Drake& Kallas, L.L.C., at (866) 809-8003.

Compliance dispute facilitator (CDF)
Physicians may consider filing a “compliance dispute” if prohibited clauses are contained in a health plan’s contract or if the health plan fails to adhere to the terms of its settlement.  After the dispute is deemed valid by the CDF, the CDF will act as the physician’s representative unless the physician or Signatory Medical Society, acting on the physician’s behalf, elects to employ separate counsel.  Below is the contact information for the Health Net CDF:

Cameron C. Staples
Neuburt Pepe & Monteith, PC
195 Church St.
New Haven, CT 06510
Phone:  (203) 821-2000
Fax: (203) 821-2009

To learn more about foundations created by the settlements, please go to the Physicians Foundation Web site.

How the Health Net Settlement Agreement helps the physician practice flyer (prepared by AMA) contains a summary of the key business practices mandated in the Health Net Settlement. Since contracts provided by Health Net to physicians in its provider network must conform to the Settlement, physicians are encouraged to review their contracts to ensure they are receiving available protections.

The HMO Settlements Web site was established in connection with this settlement among Health Net, physicians and certain medical societies in the managed care litigation that is pending in the U.S. District Court for the Southern District of Florida.

Health Net Settlement Step-by-Step Compliance Dispute Procedure

Also, get additional Health Net Settlement Fund information.

This summary has been prepared by the American Medical Association (AMA) Private Sector Advocacy unit from information provided to the AMA.

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