Since 2000, the Pomerantz firm has been actively involved in litigation on behalf of health care providers and subscribers challenging the use by insurance companies of the so-called "Ingenix database" to calculate the usual, customary and reasonable ("UCR") rates for out-of-network health care providers.  Ingenix, Inc. is a wholly-owned subsidiary of the UnitedHealth Group, which owns and disseminates the databases used by many insurers to set UCR. As previously reported, last year Pomerantz succeeded in reaching a $250 million settlement in a UCR case against Health Net, Inc., and it has negotiated and is in the process of trying to obtain preliminary approval of a $350 million settlement with the UnitedHealth Group. Pomerantz is also involved in similar actions against Aetna, CIGNA and Wellpoint, three of the major national insurers.
 
Recently, the Judicial Panel on Multidistrict Litigation elected to transfer all UCR cases pending against Aetna to the District of New Jersey, under the heading "Aetna UCR Litigation." It will be overseen by Judge Faith S. Hochberg, the same judge who had handled the Health Net litigation. A number of firms were seeking to be appointed to a leadership position in that action, including Pomerantz. A compromise agreement had been reached among the various firms to share the power, with Pomerantz to serve as co-lead counsel for the providers and other firms to serve as co-lead for the subscribers. The Court, however, didn't see it that way. By order dated July 31, 2009, Judge Hochberg established an Executive Committee of the seven primary firms who had sought leadership positions and elected to appoint Pomerantz as the sole Chair of that Committee, whereby it would effectively serve as lead counsel for the entire case on behalf of all plaintiffs.

The Court stated in its order that Pomerantz "shall be generally responsible for coordinating the activities of Plaintiffs during pretrial proceedings," and that, subject to appropriate consultation with other counsel, Pomerantz would "determine .  . . the position of Plaintiffs on all matters during pretrial proceedings and present those positions to the Court and opposing parties . . ."  Significantly, the Court further specifically acknowledged the work of Pomerantz partner D. Brian Hufford, the head of the firm's health care practice, as a critical basis for its decision.

In its decision, the Court noted that substantial progress had already been made with regard to challenging the validity of the Ingenix database to set UCR, some of which progress could be attributed to an investigation by the New York Attorney General that had been prompted, in part, by the UnitedHealth Group litigation, and in which Pomerantz played an important role. According to the Court, "[g]iven that the validity of the Ingenix databases has already been explored through the New York Attorney General's investigation and other matters, counsel for Plaintiffs are advised that the Court will favor a prompt and fair resolution of this matter that achieves a timely benefit to injured putative class members."

"The Court's order sends a strong message to both plaintiffs and Aetna that this case should be settled," says Mr. Hufford. "While we are very pleased with the decision appointing us Chair of the Executive Committee; now we have to roll up our sleeves and get to work in order to meet the Court's high expectations." 



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