Highmark Agrees To Pay Physicians $10M To Settle Lawsuit Alleging Improper Business Practices

Main Category: Primary Care / General Practice
Also Included In: Litigation / Medical Malpractice;  Health Insurance / Medical Insurance
Article Date: 04 Dec 2007 - 12:00 PDT

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Highmark has agreed to pay more than $10 million to settle a class-action lawsuit filed by a group of physicians over allegations of improper business practices, the Pittsburgh Post-Gazette reports (Toland, Pittsburgh Post-Gazette, 11/30). The lawsuit, filed in U.S. District Court for the Southern District of Florida, alleges that, over eight and a half years since May 1999, Highmark "engaged in a conspiracy to improperly deny, delay and/or reduce payment to physicians, physician groups and physician organizations by engaging in several types of allegedly improperly conduct."

Under the settlement, Highmark will pay almost $10 million into a fund, as well as pay $3.8 million in attorney fees and $7,500 per plaintiff. The number of plaintiffs involved in the settlement remains undetermined (Stouffer, Pittsburgh Tribune-Review, 11/29). The settlement also will require Highmark to make improvements to claims processing practices and establish an improved arbitration process to settle disputes with physicians. Highmark will not admit any wrongdoing under the settlement.

The court will hold a hearing Jan. 31, 2008, to consider some final issues with the settlement and decide whether to approve the agreement (Pittsburgh Post-Gazette, 11/30).

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