Case Details

Year Initiated/Committed

1995

Year Resolved

1995

Settlement Amount

$4 million in community benefits

Court

Superior Court of Massachusetts, Suffolk County

Docket Number

95-0331

Lead State

MA

Participating States

MA

Defendant(s)

Harvard Community Heatlh Plan Inc.; Pilgrim Health Care, Inc.

Case Description

State concerns about proposed merger of two large HMOs in eastern Massachusetts were resolved by Assurance of Discontinuance which provided: 1) $2.5 million in expenditures for violence prevention, health care for the homeless and AIDS education programs; 2) $750,000 program to held pay health care costs for HMO members who lose their jobs; 3)freeze on non-group and small group rates; 4) prior approval by Attorney General of future mergers, future exclusive contracts with hospitals, future exclusive contracts with physicians, future acquisition of physician groups.