Are any Humana plans or panels carved out and not eligible for potential increases in reimbursement?

No, there are no Humana plans or panels that are carved out (ineligible) for increases in reimbursements.

Can reimbursement rates go below 2003 levels?

No, reimbursements on the whole cannot go below 2003 levels. Using 2003 physician reimbursement rates as a base that cannot be decreased, Humana will increase the physician reimbursement base for doctors treating Humana patients by a total of $100,000,000 over a period of three years (i.e., 35 percent increase from 2003 base).

Is there any benefit for retired doctors or even active doctors who no longer participate in Humana plans?

As the settlement with Humana increases reimbursement rates going forward (i.e., is prospective in nature), it does not provide any benefit for retired doctors or active doctors who no longer participate in Humana plans.

Is there no provision for past under-reimbursement for current or future Humana providers?

In exchange for at least a $100 million reimbursement rate increase from the 2003 rates over the next 3 years, and establishment of a Compliance Committee, Plaintiffs waived all of their claims for past under-reimbursement by Humana. Such waiver would not, however, preclude an action in the future should Humana violate the terms of the settlement, or engage in actionable under-reimbursement conduct.

Do we expect the other defendants to settle and if so, will the terms be the same?

It is not at all unusual for additional defendants to settle once one defendant has entered into a settlement. At present, there are no settlement negotiations proceeding with Aetna, Anthem or United HealthCare. We will proceed with the litigation against the remaining defendants.

Assuming doctors can opt out, in this case, what does that really mean?

Doctors are entitled to opt out. In other words, they are entitled exclude themselves from the settlement, if they so choose. If a doctor opts out of the settlement, he or she will not receive the benefit of the $100 million increase in reimbursements, and will be entitled to pursue his or her claims against Humana individually.

Do doctors who are not now, or who have never been Humana doctors, get to participate in the opt-out, fairness hearing, etc.?

Doctors who are not now, or who have never had any contact with Humana will not participate in the Proposed Settlement.

If a doctor "just signed" a multi-year agreement with Humana, can they re-negotiate given the settlement?

Humana has committed to continue to negotiate with physicians in good faith, and nothing in the settlement effects the rights of physicians or practices to engage in individual contract negotiations. Whether a doctor or practice can renegotiate a signed contract with Humana depends upon the terms and circumstances of the doctor's existing agreement with Humana.

Can Humana meet the terms of the settlement by simply adding doctors to their panels so more are being paid?

While Humana can certainly add doctors to their panels, it is not expected that such an increase will impact the settlement. This settlement was driven by a desire to increase reimbursement rates paid to physicians in the Greater Cincinnati/Northern Kentucky Region. The settlement sets the baseline Ð not the ceiling Ð for a possible increase in reimbursement rates paid in this Region, and such additions will not dilute the increased reimbursement rate paid under the settlement.

Can Humana meet the terms of the settlement by allowing or requiring doctors to do more things and paying them for those things?

Humana has agreed to increase reimbursement rates paid over the next 3 years for services performed. This may include additional services that physicians may provide to their patients.

Who is the appropriate person(s) at Humana to contact about implications of the settlement?

Doctors may contact Humana's counsel for a referral to the appropriate person at Humana with whom to discuss implications of the settlement:
John A. West, Esq.
James K. Kareth, Esq.
Greenebaum, Doll & McDonald, PLLC
50 E. RiverCenter Boulevard, Suite 1800
Covington, Kentucky 41011
Telephone Ð (859) 655-4200
Fax Ð (859) 655-4239

Who monitors the actions of Humana over the coming three years to make sure they are living up to their end of the settlement?

The longer-term and perhaps most important aspect of the Settlement is the establishment of a Compliance Committee that, beginning in 2007 and running through 2010, which will monitor reimbursement rate negotiations between the physicians and Humana to ensure that the rates were not the product of anticompetitive activities, and that physician reimbursement rates do not return to pre-lawsuit levels. The Committee will be composed of three members Ð one selected by Plaintiffs, one selected by Humana, and the third selected by the other two members (subject to Plaintiffs' approval).

How will the money actually be allocated by Humana: proportional to current business with a practice, by specialty, depending on the negotiating strength of a practice and/or some other way?

The additional funds available will be divided among the physicians who have a contract with Humana. It will not be divided by specialty.

Are their any "most favored nation" implications, in either direction, relative to other plans or Medicare?

No, there are not any "most favored nation" implications related to the settlement.