Case Details

Year Initiated/Committed

1993

Year Resolved

1993

Settlement Amount

$50,000 charitable contribution

Court

Supreme Judicial Court of Massachusetts

Docket Number

93-1400F

Lead State

MA

Participating States

MA

Defendant(s)

Central Massachusetts Health Care, Inc. (CMHC)

Case Description

CMHC, which serves approximately 88,000 subscribers, is the sixth largest
HMO in Massachusetts. CMHC allegedly had a policy and practice of depriving optometrists of membership and participation in CMHC provider networks, solely because they were optometrists and not because of individual skills, character or
qualifications. Under the agreement, CMHC will allow optometrists to be included in its provider networks. Optometrists will be allowed to accept referrals from primary care physicians and will each be evaluated based upon education, training, experience and capabilities. In addition, CMHC contributed $50,000 to Daybreak Resources for Women, Inc., a shelter for victims of domestic violence in Worcester, Mass., to go towards health care and other services for women and children. As part of the agreement, CMHC agreed not to reduce eye care benefits to its subscribers for at least two years, and agreed to be monitored by the state to ensure compliance with the agreement.