The U.S. Supreme Court has agreed to decide whether patients can sue their health insurers for fraud under a federal anti-racketeering law.
The court will hear a case against Humana, which is accused of getting secret discounts that it did not pass on to its customers. A date for oral arguments has not been set, but a decision is expected next spring or summer.
The class-action lawsuit was filed on behalf of Humana enrollees in Nevada in 1989 under the Racketeer Influenced and Corrupt Organizations Act, which allows private parties to collect triple damages.
A lower court ruled that Humana enrollees could not sue under RICO because another federal law, the McCarran-Ferguson Act, makes states the primary regulators of insurers. Allowing the federal suit to proceed would undermine states' authority, the judge ruled. However, the 9th Circuit Court of Appeals in San Francisco reversed that ruling, saying it didn't see any conflict in applying both laws.