Judge dismisses some RICO counts

Thu, Jun 14, 2001 (11:06 a.m.)

MIAMI -- A federal judge in Miami partly dismissed lawsuits that challenged the managed care practices of six big health insurers but said he would allow plaintiffs to amend their cases.

Judge Federico Moreno of U.S. District Court rejected a motion to dismiss a claim against Humana Inc. under the Racketeer Influenced and Corrupt Organizations Act.

But he said the plaintiffs had failed to show that RICO claims against the other companies -- Aetna Inc., Cigna, United Healthcare, Foundation Health Services and the Prudential unit of Aetna -- should proceed.

The companies face more than 50 lawsuits from patients and doctors accusing them of conspiring to deny care and of withholding information about how business criteria influenced medical decisions.

On another key point, Moreno agreed with the insurers that the plaintiffs' lawyers had failed to show that their clients, who are members of health plans, had exhausted all administrative remedies provided by the insurers or that seeking such remedies would be futile.

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