This is a classic anti-trust case fact pattern. Insurance companies or any companies conspiring/colluding in an anti competitive manner to reduce competition (e.g. choices) for consumers/patients. State and federal Attorney General's should be interested in this bad behavior. Even Medicare wrote that denying claims for all ADR surgeries would have a cooling effect on this new procedure, due to their power and influence in the medical community. This may not rise to a RICO case, because in such a case we need a criminal enterprise, and anti-competitive actions may not rise to crimes. This would be a good story for an investigative reporter (60 Minutes or Anderson Cooper....)
Quote:
Originally posted by LBP:
Coley,
with the news about the ins companies getting together and almost seeming to collude on how to create a new policy...I am wondering if there is anything rising to the level of criminal activity for a district attorney to investigate...not just an invidual civil lawsuit. Your facts are very unique. Do you have anything in writing about the reasononing? Like there was a meeting with out ins co to pay only what medicare is paying?
Re your pain and surgery. I am sorry for your pain and I don't know anything about the other procedure you mentioned. best of luck. I just find what happened to you so alarming for the future of ADR.
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