The Pennsylvania Medical Society is recommending that physicians opt out of a recently announced class action settlement between the Pennsylvania Orthopaedic Society and Independence Blue Cross.
The settlement, announced last month, deals with the orthopedic society's lawsuit against the Philadelphia-based Blues plan's claims processing methods, and it applies to all physicians who have claims with the company.
But the medical society on Friday announced it opposes the settlement agreement and will present its objections at a fairness hearing Aug. 21.
In a statement sent to members, the society listed these concerns:
- Physicians must release all claims against the company, including claims in RICO class action conspiracy lawsuits against Blues plans nationwide, recently filed in a Miami federal court.
- Money from the settlement would primarily benefit surgical specialties, based on a preliminary review of available procedure codes.
- Lack of specifics. "The settlement agreement presents the settlement in broad outlines with additional detail to come later," the society says. "We believe the information now available is insufficient to make an affirmative decision."
- It is unclear whether physicians would receive $40 million under the settlement, as the Blues and the orthopedic society announced.
- The agreement's dispute resolution process does not cover such issues as medical necessity.
- The agreement would "lower the bar" for future settlements, the society states.