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Humana Settlement Information
The following documents will help you understand your rights
under the Humana settlement agreement
Pertinent information:
Date settlement reached by parties: |
Oct. 17, 2005 |
Final approval date: |
September 28, 2006 |
Value of settlements: |
In excess of $133 million |
Retrospective relief: |
$40 million to Settlement Fund |
Prospective relief: |
$75 million |
The Health Net Settlement became effective September 28,
2006. Physicians who submitted a proof of claim form to
Humana may expect payment in early 2007. We do not yet know the
amounts that the settlement will pay individual class members.
Questions about the settlement may be directed to the Humana
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 Humana CDF:
Carol
Scheele
Associate General Counsel
North Carolina Medical Society
222 North Person St.
Raleigh, NC 27601
Phone: (919) 833-3836
Fax: (919) 833-2023
To learn more about foundations created by the settlements,
please go to the Physicians
Foundation Web site.
How
the Humana Inc. settlement agreement helps the physician practice
flyer (prepared by AMA) contains a summary of the key business practices
mandated in the Humana settlement. Since contracts provided by
Humana 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 Humana, 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.
For Humana dispute procedures, click on the links below:
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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