Antitrust case against RBM moves forward for denial of services

Federal judge Leonard D. Wexler for the U.S. District Court for the Eastern District of New York has set May 2011 as the date for the health insurance antitrust case pitting Jericho Specialty Imaging (JSI), an outpatient imaging center catering to pediatric patients, against insurance radiology benefits manager (RBM) company CareCore National, which was allegedly controlled by radiology competitors.

JSI, which filed the suit in 2008, claimed it was denied reimbursement for services provided to autistic, neurologically impaired and other special needs patients, at its New Hyde Park, N.Y., headquarters since 2006, when the practice opened.

The lawsuit filed against CareCore alleges improper anti-competitive practices for refusing to allow JSI into its provider network and by denying the facility access to the majority of Oxford Health Plans, Aetna, Health Net and HIP subscribers in the Long Island and greater New York area. JSI’s antitrust lawsuit is one of several pending antitrust cases filed by private imaging facilities in the New York area.

Wexler set the trial date last week, after denying a bid by CareCore’s attorneys for dismissal of JSI’s case.

In late 2009, CareCore settled a federal antitrust case in the Southern District of New York after three weeks of testimony by plaintiff Park West Imaging, according to JSI. Details of the Park West Imaging settlement were not disclosed.

JSI is represented by Constantine Cannon, of New York City.