ACA Reports Trigon Lawsuit Advances to Appeals Court

Chiropractic plaintiffs in the federal anti-trust lawsuit against insurance giant Trigon Blue Cross Blue Shield will “vigorously appeal” an April 25 decision by U.S. District Court Judge James Jones to dismiss the case.

Calling the judge’s opinion “legally and factually wrong,” the American Chiropractic Association (ACA), Virginia Chiropractic Association (VCA) and several doctors of chiropractic and patients reportedly maintain that an appeal will allow them to challenge earlier decisions by the judge that limited evidence and discovery procedures that would have exposed “discriminatory schemes” that took place prior to 1996.

“We refuse to capitulate,” ACA president Dr. Daryl Wills commented. “Filing an appeal is a necessary step in ensuring that Trigon’s discriminatory schemes are exposed to the light of day. We are convinced that if this evidence is presented in its entirety to a federal jury, they will find Trigon guilty of antitrust violations against the chiropractic profession.”

According to ACA chairman Dr. James Edwards, “Knowing that the Wilk case took 16 years to win and went through a similar appeals process, we weren’t surprised that the judge came down in Trigon’s favor. This a first step in what we expect to be a successful lawsuit of historic proportions for the chiropractic profession.”

The landmark Wilk vs. AMA antitrust suit was successfully resolved in 1992, but not before the chiropractic plaintiffs went through a federal appeals court and the U.S. Supreme Court for a decision in their favor.

At the center of Judge Jones’s ruling was a legal finding that a Trigon advisory panel, which was composed of representatives from various Virginia medical societies, could not as a matter of law “conspire” with Trigon to limit coverage of chiropractic services and payments to doctors of chiropractic.

This, according to the ruling, is reportedly because there was not sufficient evidence that the members of the advisory panel personally benefited financially from Trigon’s discriminatory policies taken toward doctors of chiropractic.

According to Dr. Wills however, “Judge Jones ignored the 100-plus years of efforts by medical groups to prevent competition, payment of insurance monies, or referrals to doctors of chiropractic.”