From judy-doc@coollist.com Wed Apr 28 03:57:37 1999
Date: Fri, 23 Apr 1999 14:02:19 -0400
From: judy-doc List Owner 
To: judy-doc@coollist.com
Subject: Current State of the Fight against Corporate Crime in Healthcare

I just thought it might give some of us some hope to look at what's
happening especially in view of 3 recent Supreme Court decisions.  

There is much more happening.  This is only a list of what I personally
know is going on.

1) Supreme Court allows Racketeering Charges to go forward against
HUMANA for billing descrepancies.

2) Supreme Court finds against UNUM Insurance Company in UNUM v. Ward
stating that certain state laws that provide GREATER protections for
beneficiaries than the Federal ERISA law ARE NOT PRE-EMPTED by ERISA
and must be upheld by the courts.

3) Supreme Court refuses to overturn decision allowing Rick Sabo,
ex-MetLife agent to pursue Racketeering charges, thereby allowing
his RICO case against MetLife to proceed

4) Racketeering lawsuit filed by Consumer Group against Aetna claiming
massive advertising and quality of care fraud.

5) Jury awards wrongfully terminated disability claimant Ron Diamond
$58 Million Dollars in punitive damages based on General American
Insurance's scheme to terminate benefits of claimants.  General American
is appealing.

6) Numerous appeals courts upholding multimillion dollar verdicts against
insurance companies (Aetna, State Farm, etc.) and decrying corporate
policies to deny and terminate claims.

7) Judge Spencer Letts issues scathing decision against UNUM Insurance
Company in an ERISA case, Dishman v. UNUM (but refused to award punitive
damages due to his misinterpretation of ERISA).  Decision being appealed
by UNUM.

8) Numerous consumer groups and health care groups amassing extensive
evidence of widescale patterns of corruption of insurance companies and
State Insurance Departments (Health Care for All, Families USA,
Ad Hoc Committee to Defend Health Care, Consumers for Quality Care,
even the AMA)

9) Relentless lobbying and false information being spread by the insurance
industry to defame doctors, patients, and anyone who dares to challenge
them or try to legislate health care reform.

10) Ongoing investigation by government against Columbia HCA and other
for-profit hospital chains for apparent mass fraudulent billing of
medicare and other government insurance coverage.

11) Racketeering lawsuit filed by Dr. Judy Morris against UNUM Insurance
Company and numerous Massachusetts State Agencies.  Dismissed on
technical reasons.

12) Racketeering lawsuit filed against Provident Insurance Company on
behalf of abused claimant by a Chicago lawyer, Robert Holstein.  Dismissed
on technicalities.

13) Well known and legislatively sanctioned arrangement whereby the
Massachusetts Insurance Fraud Bureau, a PRIVATE INVESTIGATION AGENCY
funded by several insurance companies, also pays the salaries of 13
Assistant State Attorney Generals to prosecute their cases.

14) Doctors who treat patients with chronic illnesses being targeted
for "investigations" by State Medical Boards and targeted for harassment
and termination by HMO's.

15) Doctors goaded, coerced, bribed and intimidated to sign insurance
contracts with for-profit managed care companies containing gag clauses
limiting their ability to discuss full range of treatment options or
discuss their financial arrangements with patients for fear of contract
termination.

16) Unlicensed out of state insurance personal mandating different treatments,
changing perscriptions and denying coverage of treatments recommended by
treating physicians.

17) Countless lawsuits and legal actions ended with confidentiality
agreements foisted on exhausted, destitute victims by their own attorneys.

18) Irrational decisions being made, favoring insurance companies, by
District Court judges in violation of the law, legal precidents and
common sense.  Claimants too impoverished to appeal.

19) I have personal knowledge of 2 suicides, 1 suicide attempt, and
several suicidal "pleas for help" from despondent people that are
UNUM claimants.

20) Unconfirmed quote:  Someone told me last night that back when Hillary
Clinton was trying to get a health care program organized, she said at
one point, that the health care industry was characterized by
"unbridled greed." Shortly thereafter the Whitewater investigation and
events that followed erupted and blitzed everything else.  Coincidence????

Judydoc