August 2006

Humana settles Solomon class-action suit

Humana has agreed to a class-action settlement resolving claims on behalf of chiropractors and other healthcare providers in Solomon v. Anthem, et. al. This lawsuit has been pending before Judge Frederico Moreno of the U.S. District Court for the Southern District of Florida.

If approved by the court, Humana will pay $3.5 million to fund payments to class-member chiropractors and other healthcare providers as well as fees and costs advanced by class counsel.

Plaintiffs in the Solomon action recently filed a motion seeking to add the ACA as a named plaintiff in the Solomon case and requested that ACN Group, Inc. and United Healthcare Services, Inc. be added as defendants. The case against ACN, United Healthcare Services, and all remaining defendants is still pending.

The ACA participated, through its counsel, in the settlement discussions and is a signatory to the proposed class action settlement agreement.

In addition to the cash fund, terms of the proposed settlement agreement with Humana include:

• Changes in Humana’s business practices, intended to make its claims-editing process more transparent and reduce confusion and disagreement over payments;

• Online information provided by Humana to help providers understand its payment decisions;

• More options for chiropractors and other healthcare providers to challenge Humana payment decisions in the future, if necessary;

• Independent external reviews to resolve billing disputes; and

• The appointment of an ACA representative to a newly formed Humana healthcare provider advisory committee.

The ACA participated, through its counsel, in the settlement discussions and is a signatory to the proposed class action settlement agreement.

Source: American Chiropractic Association, ACA Today, www.acatoday.com

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