Litigation
In 2005, a class action lawsuit was brought against Concentra and its subsidiaries, Concentra Managed Care MCO and Focus Healthcare Management PPO. It alleged that Concentra and its subsidiaries engaged in silent PPO activities and unfair repricing tactics. The lawsuit was initiated on behalf of First State Orthopedics and all U.S. physicians with workers' compensation or car accident bills that had been repriced by Concentra or its subsidiaries. The complaint was based on allegations of "breach of contract/duty of good faith and fair dealing, tortious interference with existing and prospective contractual relations and unjust enrichment".
A $3.7 million settlement was reached, with Concentra agreeing to pay $2,000 to each plaintiff as well as legal expenses.[12] However, the settlement terms were criticized by many of the doctors, supported by medical professional associations, such as the American Medical Association (AMA) and the Connecticut State Medical Society (CSMS). The AMA filed an objection with the court, claiming that "the defendants' claimed modifications are illusory, impossible of verification, and in any event insufficient to rectify the [said] losses." The terms of the settlement, according to CSMS, "provide very little relief to aggrieved physicians" and would require them to "give up virtually all legal claims they may have" that are tangentially related to the claims in this suit. CSMS recommended that doctors who were substantially aggrieved consider opting out of the class action lawsuit to retain the option of pursuing an individual claim against the company in the future.[13]
In 2009, Concentra was part of a class action workers' compensation case, Josephine Gianzero et al. v. Wal-Mart Stores Inc. et al, alongside Wal-Mart and its insurance adjuster Claims Management Inc. (CMI).[14] The lawsuit was filed in Colorado federal court on behalf of 13,521 Wal-Mart employees who had received treatment for work-related injuries. According to Denver Business Journal, the workers sued Wal-Mart, CMI, and Concentra for "interfer[ing] with and limit[ing] the independent judgment of certain medical providers who treated injured workers employed by [Wal-Mart] in Colorado who sustained on-the-job injuries".[15] After fighting the charges for three years, Judge Robert Blackburn approved a settlement of $8 million, requiring Concentra to pay $4 million, through its insurer, and Wal-Mart and CMI to pay the other half. Concentra was ordered to pay $520 to each Wal-Mart employee that had been treated at one of its offices and $50 to employees who were treated at other clinics.[14]
