In a five-hour hearing that lasted into Tuesday evening, U.S. District Judge Federico Moreno said he would take a few weeks to decide whether to finalize the Aetna settlement agreement, attendees report.
Moreno had questions about how Aetna's payments to physicians are calculated and about the goals of a new foundation that would be run by medical societies and funded by Aetna, according to Archie Lamb, lead counsel in the lawsuit against Aetna, which the agreement would end.
But Lamb, who represents 19 plaintiff medical societies in the suit, which deals with billing and coding policies, says his clients and Aetna are addressing Moreno's questions and he is confident that Moreno eventually will approve the agreement.
In the hearing, "Judge Moreno let everyone who had something negative to say about the settlement say it," Lamb says.
Aetna spokesperson David Carter, who also attended the hearing, reports that 19 people and organizations presented objections to the settlement, but only seven appeared to have both standing in the lawsuit and substantive objections that Moreno would review.
Carter also reports that 1,168 doctors out of a national plaintiff class of 950,000 active and retired physicians wrote in to opt out of the settlement. Physicians who opt out can continue legal actions against Aetna but will not receive any payments from the company.
Each eligible nonretired physician would collect cash payments of $55 to $210, but by not responding to mailed notices of the settlement, more than 90% agreed to turn their payments over to the foundation, Aetna officials report.
Those payments and a direct $20 million payment from Aetna under the agreement would give the foundation a total of $95 million to spend within the next four years, Carter says.
Lamb says the medical societies previously reported the foundation would study a number of topics that had nothing to do with the lawsuit, such as childhood obesity, but Moreno was concerned that topics be limited to the lawsuit's billing and payment issues.
Lamb says the foundation's newly drafted bylaws, which he will forward to Moreno, are limited to "curing the ills of managed care." Lamb says that might include paying physician practices to improve their billing functions and educating physicians on bundling and coding rules.
At the hearing, attorneys for the original 19 plaintiff medical societies asked that eight more medical societies be allowed to join the lawsuit against Aetna and thus become part of the settlement.
Lamb says these newcomers would not join the original 19 societies in running the foundation, but they would participate in the settlement's extended review mechanism for Aetna's billing and medical necessity determinations, he says.
The eight societies seeking to join the suit are from Alabama, Arkansas, Colorado, Massachusetts, Oklahoma, Rhode Island, Denver County, Colo., and Clear Creek Valley, Colo.
The original societies that sued Aetna are from Alaska, California, Connecticut, Florida, Hawaii, Louisiana, Georgia, New York, New Jersey, Nebraska, New Hampshire, North Carolina, South Carolina, Tennessee, Texas, Washington, North Virginia, Denton County, Texas, and El Paso County, Colo.