Portsmouth

Publications

The lawyers of WhatleyKallas have been repeatedly recognized by The National Law Journal and other publications for their work in the healthcare field. For example, Kallas was recognized in a feature article entitled “In Insurance Fights, a Healthy Return for Firm.” The article highlighted the recent settlement, on behalf of a class of approximately 120,000 California consumers, of litigation against Wellpoint (Anthem Blue Cross), as well as Edith Kallas’ and Joe Whatley’s accomplishments in past healthcare cases. The settlement involved critical issues of protecting patients’ ability to access individual health insurance coverage, despite pre-existing conditions, rising health care costs and the interplay with the federal Patient Protection and Affordable Care Act.

Edith Kallas and Joe Whatley were also featured in a National Law Journal article entitled “Case Puts Doctors Back in the Driver’s Seat” for their work in restoring doctors’ power to make important medical decisions about their patients’ treatment without the interference of health plans. The article details a string of settlements Kallas and Whatley reached with the vast majority of the managed care companies in the country in the massive multi-district litigation In re Managed Care Litigation, whereby the companies were required to fundamentally and permanently change the way they interact with and pay doctors. In addition to requiring insurers to compensate a class of over 900,000 physicians for past underpayments and to change their payment practices going forward, the settlements all required insurers to adopt a definition of medical necessity based on generally accepted medical standards, and to allow independent medical experts to decide appeals when insurers deem treatments not medically necessary, thus placing important treatment decisions back in the hands of doctors rather than insurers.

Another National Law Journal article, entitled “A fairer deal for doctors,” described Edith Kallas’s work in obtaining a settlement with Wellpoint Health Networks in In re Managed Care Litigation, in which the insurer agreed to pay over $200 million and implement fundamental changes in their payment practices costing the company an additional $250 million. In addition, Wellpoint agreed to change its definition of “medical necessity” to afford physicians more control over treatment decisions, to make its payment practices more transparent, and to implement important compliance and appeals processes. The article noted that the Wellpoint settlement was only the most recent settlement on behalf of physicians in the multi-district litigation, and that it brought the total value of such settlements to over $1.5 billion.

Joe Whatley was also featured in an article in The American Lawyer entitled “Main Street Muscle.” The article described the history and theories behind the MDL In re Managed Care Ligitation, the massive RICO conspiracy action against managed care companies across the country that ultimately led to the multiple, game-changing settlements later lauded in the National Law Journal. The article also focused on Joe’s background and long history of taking on big corporations on behalf of the little guy, and highlighted how bold the managed care litigation was.

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