Humana settlement fund procedure

Retrospective relief

This summary has been prepared by the American Medical Association (AMA) Private Sector Advocacy unit from information provided to the AMA. While efforts have been made to include information likely to be of interest to most physicians, the actual settlement documents are much more extensive, contain the definitive settlement terms and should be consulted in the event of questions or if a specific situation is not addressed. Questions about the settlement may be directed to Humana Physician Settlement Administrator at (866) 254-8048 or Whatley Drake, L.L.C., at (866) 809-8003. Questions can also be directed to the HMO settlements Web site. (This link will take you off the AMA Web site. The AMA is not responsible for the content of other Web sites.) The Humana Proof of Claim Form and instructions can also be downloaded at the Web site.

Who is eligible to apply for the Humana settlement fund?
Any eligible physician, physician group or physician organization may submit a proof of claim form, based on one of the following options:

• Humana reimbursement for calendar periods of 2003, 2004 and 2005;

• Humana reimbursement for another consecutive three-year period between Jan. 1, 1990, to Dec. 31, 2004; or

• No Humana reimbursement, but submitted claims to one or more of the following payers for covered services that were provided to any individual between Jan. 1, 1990, and Oct. 19, 2005.

Aetna, Inc.
Aetna-USHC, Inc.
Anthem, Inc.
CIGNA HealthCare
Coventry Health Care, Inc.
Humana Health Plan, Inc.
Humana, Inc.
Pacificare Health Systems, Inc.
Prudential Insurance Company of America
UnitedHealth Group
UnitedHealthcare
WellPoint Health Networks, Inc.

How do I submit the proof of claim form?
The proof of claim form and instructions can be downloaded from the HMO settlements Web site. (This link will take you off the AMA Web site.) Completed proof of claim forms must be submitted by Feb. 17, 2006 to the settlement administrator at the following address:

Humana Physician Settlement Administrator
P.O. Box 4068
Portland, OR 97208-4068
Phone: (866) 833-7919

Supporting documentation
No supporting consecutive three-year period.