Navigation Links
Maldonado Medical LLC Champions Physician & Patient Rights for Better Reimbursement Schedules Nationwide

PHOENIX, Sept. 3 /PRNewswire/ -- Maldonado Medical, a Durable Medical Equipment (DME) provider servicing the southwestern United States, in continuing its commitment to physicians, patients and the organized medical community, has joined the American Medical Association (AMA) and other physician associations from several states in filing a nationwide consolidated class action lawsuit. This lawsuit is against the following health insurers: Aetna Inc., Cigna Corp. and other co-conspirators such as Wellpoint, Inc., Oxford Health Plans, Health Net, Inc., and The Health Insurance Association of America over the use of a 'rigged' database used to underpay physicians, providers and patients for more than a decade.

This nationwide class action is brought on behalf of physicians, subscribers, DME providers and other non-physician providers, as well as the American Medical Association (AMA) and several state medical associations, including the Medical Society of New Jersey, the Medical Society of the State of New York, the California Medical Society, the Connecticut State Medical Society, the Texas Medical Association, and the North Carolina Medical Society.

These organized medical communities have been forced to absorb as much as 28% reduction of the costs of treatments and services provided based on the Usual, Customary and Reasonable (UCR) allowable rates. This in turn diminishes the necessary resources to run their health care practices and stands in the way of the patient-physician relationship.

"Being a Plaintiff in this suit is unprecedented in the Durable Medical Equipment industry," states Brandon Maxon Maldonado, whom along with his brother Gregory Maxon Maldonado, own and operate Maldonado Medical. In an ongoing effort to increase reimbursement rates for physicians, Maldonado Medical is helping to spearhead efforts to keep physicians from being systematically trampled into submission and forced to accept the health insurance industry's "Out of Network" UCR reimbursement rates.

Maldonado Medical has also been fighting other types of health insurers' fraudulent claims practices since 2003. "We can no longer ignore the improper business practices of health insurers who decide to play by their own rules without any regard to patients, or the legitimate costs required to care for them," said AMA President Nancy H. Nielsen, M.D.

"We have evidence that multiple health insurance companies have attempted to put us out of business but we have taken a stand, both for the rights of our patients and physicians, as well as our own", says Brandon Maxon Maldonado. With health insurance reform in the forefront of the American political landscape, health insurance companies have spent millions of dollars trying to convince people that patient care is of the utmost importance. The real fact is that the health insurance industry continues to earn billions of dollars and record profits at the expense of its physicians and patients.

According to New York Attorney General Andrew Cuomo, health insurance companies have been able to defraud physician's reimbursements by up to 28% nationwide.

"This class action is about a secret and intentionally concealed agreement among health insurers to depress reimbursements, thereby raising the cost of reimbursed health care services for consumers and providers." (As outlined in the consolidated class action filed on July 1, 2009 in US State District Court, District of New Jersey.)

When plaintiffs such as Maldonado Medical bring class action lawsuits, they are often taking on the wealthiest corporations in the world. These corporations will allocate massive amounts of their resources into the effort to prevent any recovery or meaningful change in practices. The Maldonado Medical legal team is also exploring options to participate in various other class action lawsuits. Examples of other lawsuits may include the practice of using post-payment audit processes to place pressure on providers. The insurer's intention is to claim that the providers have been overpaid in the past for services that are not deemed to be covered under its health care policies for various reasons. This includes stating that the services are purportedly experimental and/or investigational. They feel this will intimidate physicians into not using "Out of Network" benefits that patients have paid substantial amounts for.

"Health Insurance companies consistently invalidate acceptable medical procedures thus making the patient responsible for their health care costs," states Gregory Maxon Maldonado. "In making demands like this, health insurance companies fail to provide even minimal due process, which is required under the Employee Retirement Income Security Act (ERISA), before health insurance companies can make any unfavorable health benefit determinations. These health insurance companies continue to violate the legal rights of physicians, non-physician providers and the premium paying patients."

"We are involved in this historic class action lawsuit to assist physicians and patients in defending themselves. We have expended enormous resources to create a proprietary database of thousands of violations of ERISA and to create transparency in this corrupt system of reimbursement schedules with the intent to change the system in making it more fair for doctors and patients," says Brandon Maxon Maldonado.

On June 15, 2009, in the face of overwhelming accusation and historical precedence, a federal judge ordered the Aetna class action case to a preliminary settlement conference. It is at this conference where Maldonado Medical, along with the American Medical Association and associated plaintiffs, will attempt to reform "Out of Network" reimbursement procedures and provide physicians, non-physician providers and subscribers the recompense that is long overdue from these fraudulent and conspiratorial acts.

For more information, please visit:

SOURCE Maldonado Medical LLC
Copyright©2009 PR Newswire.
All rights reserved

Related medicine news :

1. Maldonado Medical LLC Forms Strategic Alliance to Provide Timely Physician Reimbursement From the Health Insurance Industry
2. MSU engineering team designs innovative medical device
3. ATS Medical to Present at the 2007 Thomas Weisel Partners Healthcare Conference
4. Providence St. Joseph Medical Center, Caregivers Reach Agreement on a Union Contract
5. Owner and Operator of Florida Durable Medical Equipment Company Convicted of Medicare Fraud
6. Father and Daughter From Tanzania Receive Their First Medical Examination in Newport Beach
7. Doctors and medical ethicist discuss whether doctors should participate in capital punishment
8. Preparation for Natural Disasters Critical for People With Diabetes, Chronic Medical Conditions
9. Doctors and Medical Ethicist Discuss Whether Doctors Should Participate in Capital Punishment
10. Symmetry Medical Completes Acquisition Of Specialty Surgical Instruments
11. Milestone Scientific Announces Successful Completion of its Collaboration Agreement With Carticept Medical
Post Your Comments:
(Date:11/27/2015)... ... November 27, 2015 , ... According to an article ... the way that they are handling security in light of the recent terrorist attacks ... in an attempt to stop an attack from reaching U.S. soil. Especially around special ...
(Date:11/27/2015)... ... November 27, 2015 , ... A team of Swiss ... to treat it. Surviving Mesothelioma has just posted the findings on the website. ... Zurich analyzed the cases of 136 mesothelioma patients who were treated with chemotherapy followed ...
(Date:11/27/2015)... ... November 27, 2015 , ... "When ... said an inventor from Hillside, N.J. "Many people catch diseases simply from sitting ... individuals will always be protected from germs." , He developed the patent-pending QUDRATECS ...
(Date:11/27/2015)... ... ... The print component of “Supporting Our Caregivers” is distributed ... Minneapolis, South Florida, with a circulation of approximately 250,000 copies and an estimated ... media strategy and across a network of top news sites and partner media ...
(Date:11/27/2015)... ... ... MPWH, the No.1 Herpes-only dating community in the world, revealed that over 50% of its ... 3.7 billion people under the age of 50 – or 67% of the population - ... estimates of HSV-1 infection . , "The data shocks us highly!" said Michelle Li, ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)... THOUSAND OAKS, Calif. , Nov. 25, 2015 /PRNewswire/ ... of a Biologics License Application (BLA) with ... Administration (FDA) for ABP 501, a biosimilar candidate to ... the first adalimumab biosimilar application submitted to the FDA ... biosimilar pathway. Sean E. Harper , M.D., ...
(Date:11/25/2015)... On Tuesday, November 24, 2015, the ... Wright Medical Technology, Inc. for product liability and ... implant device, awarded $11 million in favor of ... and three days of deliberations, the jury found ... designed and unreasonably dangerous, and that Wright Medical ...
(Date:11/25/2015)... -- Allergan plc (NYSE: AGN ) today announced that ... York State Attorney General,s Office to end the ... statutes with the Attorney General over the decision of Forest ... selling the now generic version of memantine immediate release tablets.  ... released its counterclaims against New York , ...
Breaking Medicine Technology: