Corporate Governance

New York Times Highlights Pomerantz? Role in $350 million settlement with United Healthcare

By Carolyn Moskowitz

An article by Alison Leigh Cowan in today?s New York Times highlights the Pomerantz Firm?s primary role in a recent $350 million settlement with United Healthcare over its use of a flawed database to determine usual, customary and reasonable (?UCR?) rates for out-of-network healthcare services, and in serving as a catalyst for New York Attorney General Cuomo?s investigation into the health insurance industry. As the story reports, a ?breakthrough came when lawyers for the attorney general?s office consulted? with Mr. Hufford, leading to a ?collaboration? between the AG?s office and Pomerantz that ?brought results.? The United Healthcare settlement, which is believed to be the largest monetary settlement of a health care class action to date, was granted final approval by Judge Lawrence McKenna of the Southern District of New Jersey on October 5, 2010, after appointing Pomerantz as Lead Settlement Counsel. Pomerantz was also Co-Lead counsel in a similar class action against Health Net, which settled for $215 million before Judge Faith Hochberg of the District of New Jersey in 2008. Judge Hochberg subsequently appointed the Pomerantz Firm to serve as Chair of the Plaintiffs? Executive Committee in the Aetna UCR multidistrict litigation, pointing that it had ?similarly appointed Pomerantz to be Plaintiffs' spokesman to the Court in the Health Net litigation because the Court found D. Brian Hufford, Esq. to be the attorney most capable of presenting Plaintiffs' positions in a clear and concise manner.?  Pomerantz also serves as Co-Lead counsel for providers in UCR litigations pending against CIGNA and Wellpoint in New Jersey and California, respectively.

As a follow-up to its UCR successes, Pomerantz is now pursuing actions against insurance companies for improperly recouping funds from providers based on flawed post-payment audits. The central claims under the Employee Retirement Income Security Act of 1974 (?ERISA?) have already been upheld in Pomerantz? action against 23 Blue Cross and Blue Shields entities, and intense nationwide discovery is now proceeding. Recently, the Pomerantz Firm also obtained a significant decision in the District of Rhode Island when the court found that ERISA ?completely preempts? the state law claims brought against two providers by Blue Cross Blue Shield of Rhode Island seeking recoupment of alleged overpayments, thereby sustaining the central legal theory in all of Pomerantz? recoupment cases.

Full post as published by PomTalk on October 27, 2010 (boomark / email).