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CareCore to appeal antitrust verdict

by Brendon Nafziger, DOTmed News Associate Editor | January 17, 2011
CareCore National LLC. said last week it would appeal a multimillion dollar verdict in a case that found the radiology benefits manager violated antitrust laws by preventing a handful of practices offering stand-up MRIs from joining major insurance networks in New York.

Following a two-week trial in November, a jury in a federal court in the Eastern District of New York awarded seven radiology practices $11.7 million in damages, which by law, are to be tripled. Including attorney fees and other costs, Bluffton, S.C.-based CareCore's total bill is expected to hit $40 million.

In the case, the radiology groups argued that CareCore, which controlled access to insurance networks, had a conflict of interest, as it was owned by radiologists who could compete with the plaintiffs for business, according to their law firm, Constantine Cannon.
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"CareCore is very disappointed in the jury verdict that was issued on Nov. 30th," Mike Joslin, executive vice president of CareCore, told Bluffton Today by e-mail. "We continue to believe that we acted properly, in compliance with the law, and in the interest of quality, cost-effective health care."

In the suit, the stand-up MRI centers said CareCore unfairly prevented them from becoming in-network providers for Oxford, Aetna, HIP and HealthNet.

Stand-up MRIs let patients be scanned in various weight-bearing positions, in order to better diagnose the source of their back pain, according to the plaintiffs.