Physicians in Cincinnati and northern Kentucky reached an agreement with Aetna, the second of four national payers to settle in a 2002 antitrust lawsuit, and the agreement received preliminary approval from circuit courts in each state.
If the agreement is given final judicial approval, physicians would receive reimbursement increases of about 30%, or $22.5 million, over a three-year period, said Stanley Chesley, an attorney for the plaintiffs with Waite, Schneider, Bayless & Chesley Co., Cincinnati. Aetna also would pick up $1.8 million in attorneys fees.
Cincinnati-area physicians sued Aetna, Anthem, Humana and UnitedHealthcare in 2002, alleging that the insurers engaged in "an anticompetitive and illegal combination or conspiracy" to depress physician reimbursement.
Terms of Thursday's proposed settlement were virtually identical to the settlement reached with Humana in late 2003, Chesley said. Humana, which had a larger share of the Cincinnati-area market than Aetna, agreed to pay $100 million more in reimbursement and $6 million to cover attorneys fees and court costs.
Anthem and UnitedHealthcare have not settled.
"Anthem and United are going forward on discovery and, if necessary, we'll go forward to trial," Chesley said.
Allan Greenberg, president of Aetna's North Central Region, said in a news release, "We are pleased with this settlement and look forward to better cooperation with physicians in the Cincinnati area as we work together to create a healthcare system that provides quality affordable medical care for all.
"It also continues an effort Aetna began several years ago to work more collaboratively with physicians, and to improve the healthcare delivery system in ways that make it easier for physicians and insurers to work together with greater trust."