CareCore to appeal antitrust verdict

CareCore National of Bluffton plans to appeal a jury's verdict in a health care antitrust trial in which the company faces a judgment of more than $30 million.

New York law firm Constantine Cannon, representing several New York radiology practices and their medical-management company, argued that CareCore "conspired to unreasonably restrain trade in the market for commercially insured outpatient radiology procedures," according to its announcement last month.

A jury awarded more than $11 million in damages -- which by law are to be tripled -- after a trial of more than two weeks in the U.S. District Court for the Eastern District of New York, according to the announcement.

The firm said the total judgment against CareCore and its subsidiaries could be nearly $40 million, including costs and attorneys' fees.

CareCore is "very disappointed" in the verdict, executive vice president of sales and marketing Mike Joslin said in an e-mail, but said the verdict has had "no impact" on CareCore's operations.

"We continue to believe that we acted properly, in compliance with the law, and in the interest of quality, cost-effective health care," Joslin wrote. "We will pursue all available appeals and are confident that we will ultimately prevail."

CareCore was founded in 1994 and moved its headquarters from Wappingers Falls, N.Y., to Bluffton in 2007.

The company -- which manages the cost, quality and safety of health insurance plans -- employed about 400 in the area and about 1,000 nationwide as of March, when it began construction of a new corporate headquarters expected to house another 150 employees at Buckwalter Place.

The plaintiffs offer the "Upright MRI," which their lawyers say is the only MRI that can scan patients in weight-bearing positions, so patients can feel pain and health care providers can better diagnose ailments such as spine injuries.

The plaintiffs alleged CareCore and radiologists who own it acted as a gatekeeper to some of the largest insurance-company radiologist networks in New York, conspiring to boycott the plaintiffs and keep them from becoming providers in the networks.

That protected the radiology practices of CareCore's owners from competitive threats that would have hurt their individual medical practices, according to Constantine Cannon's announcement.

It also harmed thousands of patients who were effectively prevented from receiving Upright MRI scans, the firm said.

Matthew Cantor, Constantine Cannon's lead attorney in the trial, said the actions of benefits managers such as CareCore that are owned and controlled by physicians must be free of conflicts of interest so patient welfare is not compromised.

"This sends a message across the bow of physicians," Cantor said.