Opinion ID: 3044284
Heading Depth: 3
Heading Rank: 1

Heading: RICO and Antitrust Allegations

Text: With respect to the RICO and antitrust claims, Appellants’ argument falls far short. In reasoning adopted by the District Court, the Magistrate Judge observed that the Appellants “d[id] not dispute that they were aware well before entering into the Settlement Agreement about WellPoint’s utilization of the Ingenix Database in order to allegedly engage in their industry-wide conspiracy to underpay providers.” R&R at 11. The Magistrate Judge continued: “[T]aken as a whole, the allegations listed in the Complaint clearly relate to the alleged conspiracy of WellPoint and other managed care institutions to underpay providers for their services.” Id. at 13. 10 Magistrate Judge Torres noted, and the District Court agreed, that Plaintiffs had the option of seeking to enforce the Settlement Agreement if WellPoint had not complied with it, but stated that Appellants could not “get another bite at a very devoured apple if they are not happy with consideration they received in exchange for their broad release.” Id. at 13. 10 In comparison, consider our opinion in Doctors Health, Inc. v. Aetna, 605 F.3d 1146 (11th Cir. 2010). There, Appellants appealed the district court’s determination that their breach of contract claim had been released in a settlement agreement from an earlier class action. We vacated that determination, holding that the release did not bar Appellants’ breach of contract claim where that claim “share[d] no factual basis” with the complaint in the earlier class action. Id. at 1151. 26 Case: 12-14013 Date Filed: 06/18/2014 Page: 27 of 51 In adopting the R&R, the District Court properly determined that the Settlement Agreement released the Appellants’ RICO and antitrust claims in the UCR MDL. First, the record fully supports the District Court’s finding that Appellants’ RICO and antitrust claims arose out of the claims at issue in MDL 1334. The RICO and antitrust claims in the UCR MDL echo the earlier allegations in MDL 1334 – that WellPoint engaged in a scheme to underpay healthcare providers for claims through the use of the Ingenix database. The Second Consolidated Amended Complaint makes clear that the conspiracy enterprise “was formed in 1998” and that the antitrust conduct also began “at least as early as January 1, 1998.” UCR MDL D.E. 113-1 (Second Consol. Am. Compl.) ¶¶ 288, 369. Second, the factual record clearly demonstrates that these claims could have been asserted at the time of the Effective Date, since all facts necessary to state a cause of action had occurred long before the Settlement Agreement took effect. The fact that Appellants seek to base the new claims on certain conduct post-dating the Effective Date does not change this conclusion. Because they merely constitute a continuation of the conspiracy alleged in MDL 1334, WellPoint's purported bad acts are best seen as new, overt acts within an ongoing conspiracy, rather than new claims in and of themselves. Moreover, Appellants' decision to release claims stemming from the conspiracy alleged in MDL 1334 in no way interfered with their ability to obtain 27 Case: 12-14013 Date Filed: 06/18/2014 Page: 28 of 51 relief from ongoing violations of the Settlement Agreement. Through its Approval Order, the district court retained jurisdiction over “all matters relating to (a) the interpretation, administration, and consummation of the Settlement Agreement and (b) the enforcement of the injunctions described[.]” Approval Order ¶ 27. Although Appellants were barred from asserting new claims premised on violations of the Settlement Agreement, they could have sought relief from such violations through the procedure to which they consented: namely, through a motion in the district court to enforce the Settlement Agreement and Approval Order. These claims thus arose “on or before the effective date,” “could have been asserted” against WellPoint, and “ar[o]s[e] out of, or [were] in any way related to any of the . . . facts, acts, events, transactions, occurrences, courses of conduct, representations, omissions, circumstances, or other matters referenced” in MDL 1334. 11 Settlement Agreement § 13.1(a). The RICO and antitrust claims therefore constitute Released Claims under § 13.1 of the Agreement. Because the Settlement Agreement released these claims, the District Court did not abuse its discretion by ordering Appellants to withdraw them and holding Appellants in contempt when they refused to comply with that order. 11 Appellants argue that plaintiffs can assert continuing violations of RICO, however, the claims clearly arose before the Effective Date and could have been asserted against WellPoint at that time. 28 Case: 12-14013 Date Filed: 06/18/2014 Page: 29 of 51