An unusual antitrust lawsuit against a Canton, Ohio, hospital and its health plan subsidiaries is set to go to trial Oct. 31, after a state judge denied a request to dismiss the case.
A judge in Stark County (Ohio) Common Pleas Court ruled that "genuine issues of material fact exist on all counts" in the case against 592-bed Aultman Hospital, its parent, Aultman Health Foundation, and their three insurance businesses, AultCare Corp., AultCare Third Party Administrators and McKinley Life Insurance Co. All but McKinley, a reinsurance business, are not-for-profits.
Hummel Insurance, an independent brokerage firm, also was named.
The lawsuit, brought by Canton-based Professional Claims Management, a privately owned for-profit third-party administrator, accused the foundation and its companies of conspiring to steal claims business through a variety of allegedly illegal practices, including suspect payments to insurance brokers (June 20, p. 6).
The case is noteworthy partly because of the allegations of secret payments to independent brokers, a subject of interest to at least three state attorneys general. Those investigations, however, so far have focused on large insurance companies, not hospital-owned or -operated plans.
The Aultman foundation contends that its conversion-support payments are a legal and proper way to compensate brokers for switching to new plans. An Aultman spokesman said the companies would be vindicated in court.
"We continue to maintain that this legal action is nothing more than a disgruntled competitor complaining that it is unable to compete with Aultman's pricing, quality and service," spokesman Timothy Beauch said in a news release.
Professional Claims Management founder and Chief Executive Officer David Bratton said he was pleased by the judge's ruling. "We were confident this would go to trial, and we are preparing for that," Bratton said.