Constantine Cannon Attorneys Win Important Healthcare Antitrust Jury Trial Against CareCore National, LLC

Case has widespread implications for healthcare system as health reform is implemented

Dec 01, 2010, 13:05 ET from Constantine Cannon LLP

NEW YORK, Dec. 1, 2010 /PRNewswire/ -- Constantine Cannon LLP won a closely-watched healthcare antitrust trial against CareCore National, LLC, a radiology benefits management company.  

The verdict was reached late Tuesday in the U.S. District Court for the Eastern District of New York. After a more than two-week trial, the jury awarded over $11 million in damages to the plaintiffs in the case, which are to be trebled by law. The total judgment, with costs and attorneys fees is expected to be close to $40 million.

The jury found that CareCore, in league with New York-area radiologists and radiology practices that owned and/or governed CareCore, conspired to unreasonably restrain trade in the market for commercially-insured outpatient radiology procedures.  The jury also found that these restraints harmed the plaintiffs -- several New York radiology practices and their medical management company -- that offer unique and medically necessary Upright MRI services.  The Upright MRI is the only MRI that can scan patients in the weight bearing positions that patients actually feel their pain.  By doing so, Upright MRIs diagnose patient ailments, including those related to the spine, that no other MRI can.

Plaintiffs alleged that CareCore and its radiologist owners acted as a gatekeeper to some of the largest insurance company radiologist networks in New York.  They further alleged that CareCore and its radiologist owners conspired to boycott plaintiffs and other providers of Upright MRI services from becoming participating network providers for these large insurance companies.  The purpose of the alleged conspiracy was to shield CareCore owner radiology practices from competitive threats, such as those posed by plaintiffs, that would have diminished the profitability of their individual medical practices.  Plaintiffs claimed the alleged conspiracy harmed thousands of patients covered by these large insurance plans, who were effectively prevented from receiving Upright MRI scans.

The verdict has widespread ramifications for the healthcare profession, particularly in light of the health reform bill currently being implemented. This case demonstrates that decisions on network formation or preauthorization of medical services by insurance companies or their benefits managers must be free of conflicts-of-interest or face the danger of violating antitrust law.

Lead Constantine Cannon trial attorney Matthew Cantor said: "This verdict is not just important for my clients, but for patients everywhere.  The evidence in this case showed that even CareCore considered the Upright MRI to be medically necessary and that, nonetheless, CareCore and its owners denied patients the ability to benefit from these important diagnostic procedures.  The actions of benefits managers that are owned and controlled by physicians, like CareCore, must be scrutinized to ensure that patient welfare is not compromised. Constantine Cannon expects that the defendants will attempt to overturn the jury award either in post-trial motion practice or on appeal.  If that occurs, Constantine Cannon will vigorously defend the decision of the jury."

Along with Mr. Cantor, the Constantine Cannon trial team included attorneys Axel Bernabe, Gary Malone, Sacha Boegem and Marlene Koury.

The case is Stand-Up MRI v. CareCore National, E.D.N.Y. Case No: 08 Civ. 2954 (LDW) (ETB).

About Constantine Cannon LLP

Constantine Cannon LLP has deep expertise in practice areas that include antitrust and complex commercial litigation, government relations, employment matters, securities and e-discovery.  The firm's antitrust practice is among the largest in the nation, with more than 30 attorneys representing both plaintiffs and defendants in complex antitrust litigation. Constantine Cannon also counsels corporations, trade associations and government entities on antitrust compliance, mergers and acquisitions, and antitrust policy.

SOURCE Constantine Cannon LLP