Dr. Lawrence Shipley of Granite City has filed 12 Class Action Lawsuits in Madison County.
Granite City Chiropractor Lawrence Shipley, D.C.'s class action complaint against CCN Managed Care and First Health Group will be heard in court Dec. 28 on defendant's motion to dismiss or alternatively stay and compel arbitration.
Since Feb. 26, 2003, Shipley has been named a plaintiff in 12 class action suits filed in Madison County Circuit Court. He is represented by The Lakin Law Firm in all cases.
Shipley claims in July of 1995 he entered into a provider agreement with CCN, and at the time, CCN marketed its network as being a group health and workers' compensation network.
CCN is one of the nation’s largest PPO networks.
Unbeknownst to him and other class members, Shipley claims CCN secretly conspired to increase its profits and the profits of its insurance company clients by launching a CCN auto network.
“CCN began selling rights to discounted rates under its network to auto insurance companies, secretly setting up an ‘auto network’ unknown to plaintiff in about 2000 or 2001,” the complaint states.
After CCN was acquired by First Health, Shipley claims First Health joined in the CCN conspiracy and continued to market the CCN "auto network" and provide access to CCN discounts to insurers that First Health knew were not entitled to take such discounts.
Shipley claims a $42 patient charge on June 29, 2001 for a Farmers Group Insurance auto policy insured, was paid at $36 and noted “PPO Svngs” of $6.
Another charge Shipley submitted to Farmers on Sept. 26, 2001, was reduced by 60 cents, and Shipley alleges Farmers reduced the billed amounts pursuant to the purported CCN agreement. Shipley claims that in the explanation of benefits, it states, “CCN Auto Provider Network.”
MetLife also reduced the billed amounts pursuant to the purported CCN agreement, according to Shipley. He claims the benefits explanation states, “A network discount has been applied in accordance with your CCN preferred provider contract.”
Dr Shipley also has pending class action cases against MetLife and Farmers Insurance.
Shipley alleges that by secretly signing up numerous auto carriers as payors under the CCN network, CCN breached its payor agreement with him, and also deceived him.
Shipley also claims there is no written payor agreement between CCN and Farmers, and Farmers had no right to take CCN network discounts for this additional reason.
“By providing confidential network provider names and rates to Farmers (or its agents) and enabling Farmers to take improper network discounts, CCN has breached its contract with plaintiff and deceived plaintiff,” the complaint states.
Shipley's justification for a class action suit is based on the numerous healthcare providers who may have unknowingly been duped. But even if they had been aware of "CCN's sophisticated scheme...the amount in controversy would be too small to justify the expense of litigation," according to the suit.
Shipley and the class are seeking an amount to be determined at trial but in no event shall the recovery to any class member exceed $75,000.
Circuit Judge Andy Matoesian will hear the motion at 9 a.m. in courtroom 351.
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