Doctors’ antitrust case going to arbitration

By DAN MARGOLIES
The Kansas City Star

A state appeals court has ordered a long-running antitrust case by 3,000 area doctors against some of the area’s biggest health insurers to be submitted to arbitration.
The Missouri Court of Appeals on Monday reversed a lower court ruling, agreeing with Blue Cross and Blue Shield of Kansas City and United Healthcare Services that the antitrust claims were covered by arbitration agreements.
The court, in a unanimous decision by all 11 judges, ruled that Jackson County Circuit Judge Charles Atwell had erred when he denied the insurers’ motion to compel arbitration.
Atwell had determined that, because the antitrust claims could be brought without reference to the underlying contracts between the physicians and the insurers, they were not subject to arbitration.
He also ruled that, even if the claims were subject to arbitration, the arbitration agreements were “unconscionable.”
But the appeals court concluded that the physicians’ antitrust allegations pertained to matters covered by their contracts with the insurers and therefore were covered by the arbitration agreements.
It also held that because Atwell had failed to find that the agreements were “procedurally unconscionable,” he wrongly overruled Blue Cross’ and United Healthcare’s motion to compel arbitration.
Lynn McCreary, an attorney for Blue Cross, expressed satisfaction with the decision, saying the case should have been sent to arbitration in the first place.
“Blue Cross truly does value its contractual relationships with its physicians, and we think the right result was to uphold that kind of relationship,” she said.
Robert Horn, an attorney for the physicians, said his clients were content to pursue their claims in arbitration and were “ready to proceed.”
The case, which was filed in 2005, alleges that Blue Cross, United Healthcare and Coventry Health Care of Kansas violated antitrust laws by fixing prices and engaging in other monopolistic behavior.
Although Coventry, like Blue Cross and United Healthcare, had arbitration clauses in its physician contracts, it chose not to enforce them.
The defendants have denied that they conspired to suppress physician reimbursements and maintain that the lawsuit is without merit.
In March, Humana Inc., one of the original defendants, agreed to pay $2.8 million to settle the allegations against it. More than 2,200 doctors are eligible to participate in that settlement.
The case before Atwell is one of several lawsuits arising from the same underlying facts.
In a companion antitrust action in Wyandotte County, Judge Ernest Johnson, in contrast to Atwell, sent the case to arbitration.
Two other cases were originally filed in Jackson and Wyandotte counties and have since been consolidated in federal court in Miami.