Get To The Head Of The Class.
CIGNA Settlement Management
2012 UPDATE
There have been several delays in the CIGNA Settlement proceedings since
Judge Davis passed last year. However, the process is now proceeding in a
positive direction. Thomas Schultz has been appointed as the new arbitrator.
Arbitrator Schultz requested a summary of the settlement to date from both
parties. These filings resulted in several hearings last year. During the
hearings, we requested discovery and proposed a timeline for resolution.
According to the timeline that MCAG has proposed, all documents and
depositions should be gathered and completed by later this summer, with a
cumulative hearing in the fall. Arbitrator Schultz gives all indications that
he is very engaged in the proceedings, and shares our interest in resolving the
arbitration as quickly and efficiently as possible.
Although major updates are not likely until, perhaps, this summer, there will
likely be several hearings and discussions over the next few months. Thank you
for your continued patience. We realize that the process has been, and
continues to be, painfully slow, but MCAG is encouraged that this next round of
hearings will propel this matter towards resolution.
2011 UPDATE:
There have been several delays in the CIGNA Settlement proceedings since
Judge Davis passed last year. However, the process is now proceeding in a
positive direction. Thomas Schultz has been appointed as the new
arbitrator. Arbitrator Schultz requested a summary of the settlement to
date from both parties. These filings resulted in several hearings in May.
During the hearings, we requested discovery and proposed a timeline for
resolution.
According to the timeline that MCAG has proposed, all documents and
depositions should be gathered and completed by later this summer, with a
cumulative hearing in the fall. Arbitrator Schultz gives all indications
that he is very engaged in the proceedings, and shares our interest in resolving
the arbitration as quickly and efficiently as possible. To this end,
Arbitrator Schultz has scheduled standing conference calls every few weeks to
ensure that progress is continually made between MCAG, CIGNA, and the settlement
administrator.
Although major updates are not likely until, perhaps, this summer, there will
likely be several hearings and discussions over the next few months. Thank
you for your continued patience. We realize that the process has been, and
continues to be, painfully slow, but MCAG is encouraged that this next round of
hearings will propel this matter towards resolution.
Please rest assured that resolving this settlement satisfactorily for our
clients remains the highest priority for MCAG. In the meantime, please
feel free to contact a MCAG representative
if you have any questions, or if we can be of any further assistance.
Although MCAG has been fighting for claims to be paid under the CIGNA
Settlement for the past five years, we are cautiously optimistic that there will
be positive movement forward in the near future.
Earlier this year, the arbitration took an unexpected turn. Unfortunately, Judge
Davis, the arbitrator hearing our case, passed away in late May. We are in the
process of finding a new arbitrator or arbitration panel. We expect that the
arbitration will not proceed until early 2011.
MCAG certainly understands and shares Class Member frustration with the delays
imposed thus far, but please rest assured that resolving the CIGNA Settlement
satisfactorily for our Class Member clients remains a priority.
Class Action Management
Over the last several years, some of the nation’s largest health insurers have
settled cases outside of court that alleged improper payment of medical
providers’ claims. And the landscape is continually changing, with new
revelations of impropriety regularly resulting in new settlements. MCAG is the
industry leader in managing the requirements of recovering funds under these
settlements for its clients, submitting claims and protecting physician’s rights
throughout the process. MCAG clients’ settlement claims meet all necessary
requirements, leaving no loopholes for insurers and securing maximum
reimbursement for you.
In addition to the retrospective settlement payments, practices are now entitled
to new rights and remedies that were gained through the settlement negotiations.
MCAG maintains first-hand knowledge of these benefits and is available to answer
your questions at any time. Through our prospective and retrospective audits,
MCAG can assist with identifying and collecting underpayments, as well as
contract organization and negotiation, helping to ensure that your organization
takes full advantage of all of the settlement opportunities.
As of January 21, 2009, BCBS plans are bound by the Settlement Agreement to
adopt better business practices. These provisions include:
- Payment of add-on codes without reduction for Multiple Procedure Logic
- Separate recognition and payment of E&M codes appended with a 25 modifier
when billed with a service procedure or surgical code
- Separate recognition and payment for supervision and interpretation and
radiologic guidance codes
- Payment for codes submitted with 59 modifiers to the extent they follow CPT
rules regarding designation of separate procedures
- 90 days’ advance notice of material adverse changes
- Prohibition on global periods for surgical procedures longer than CMS’, and
- Prohibition on automatic reduction of CPT codes to codes of lesser
intensity
If you are having any problems with BCBS, or any questions regarding
prospective relief, please contact MCAG for assistance with enforcement of these
Settlement Agreement provisions.