American Specialty Health Group Files Suit Against Healthways for Its "Aggressive and Illegal Campaign to Drive Out Competition..."


SAN DIEGO, Dec. 14, 2011 (GLOBE NEWSWIRE) -- American Specialty Health Group, Inc. (ASH), the American Specialty Health Incorporated subsidiary that provides the Silver&Fit® Fitness Program for Medicare Advantage Plans, filed suit against its competitor, Healthways, Inc., on December 2, 2011, in the Southern District of California. The lawsuit concerns Healthways' SilverSneakers® program and aims to stop Healthways' "aggressive and illegal campaign to drive out competition in the "Fitness Program Market with Medicare Advantage Plans" by preventing ASH, its only serious competitor, from selling..."

In the complaint, ASH alleges claims of Intentional/Tortious Interference with Contract/Contractual Relations, Intentional/Tortious Interference with Business Relations/Prospective Economic Advantage, and violations of California's Unfair Competition Law, California Business and Professions Code Section 17200, et seq. The complaint alleges Healthways, which controls (or provides) more than sixty percent of the Fitness Programs for the Medicare Advantage market, has resorted to "illegal contracting strategies to freeze out its competitors" in order to retain its market dominance.

Specifically, ASH alleges that Healthways "insists that its SilverSneakers contracted fitness facilities sign an exclusivity contract that prevents these facilities from contracting with ASH or any other competitor offering a "Fitness Program for a Medicare Advantage program and that Healthways "aggressively" and "selectively" "enforces the exclusivity provision… threatening to terminate or sue contracted facilities that sign a competing contract with ASH." ASH contends that these methods "prevent ASH from forming a competitive network of Silver&Fit fitness facilities, thereby depriving Medicare Advantage" plans, "and ultimately Medicare beneficiaries, of ASH's Silver& Fit program…." ASH further alleges that by "foreclosing ASH from competing for and securing contracts with Medicare Advantage/Supplement contractors, Healthways is able to maintain its SilverSneakers prices high while providing a program that is inferior in quality."

The complaint cites five examples of  "Healthways' knowing and malicious selective threats to enforce its exclusivity clauses to ASH's detriment," which ASH contends have led to damages in excess of $11,000,000 in lost contracts. The examples include lost contracts with Presbyterian Healthcare Services, Lovelace Health Plan, Independence Blue Cross, and Humana of Arizona, and conduct that has jeopardized ASH's contract with Excellus Blue Cross Blue Shield.

Through the lawsuit, "ASH seeks to stop Healthways' illegal activity in order to allow a competitive market to exist for Medicare Advantage" plan Fitness Programs. Apart from seeking $11,000,000 in damages, ASH seeks an injunction of "Healthways' unlawful, unfair, and fraudulent conduct," and "restitution as authorized by law." 

The case is American Specialty Health Group, Inc. dba American Specialty Health Networks v. Healthways, Inc., case number 11-cv-2819, in the U.S. District Court for the Southern District of California. The case can be found here: http://www.ashcompanies.com/resources/pdf/ASHGroupComplaint.pdf.

About Silver&Fit®

The Silver&Fit Program is an integrated fitness and healthy aging program for Medicare beneficiaries who want to improve their quality of life by exercising more. This, in turn, may help them lower their risk for heart disease, strokes, and other chronic conditions; cope with existing medical issues; prepare for medical procedures; and prevent falls. Silver&Fit members have access to no or low-cost memberships at a comprehensive Silver&Fit-contracted network of fitness facilities and exercise centers. For more information, visit SilverandFit.com or call 1-800-848-3555.

About American Specialty Health Incorporated

The Silver&Fit program is provided by American Specialty Health Group, Inc. a subsidiary of American Specialty Health Incorporated (ASH). ASH is a national health services organization that provides a total population health management program, specialty network management programs, and fitness programs to health plans, insurance carriers, employer groups, and trust funds. Based in San Diego, ASH has more than 800 employees and serves over 25.9 million members. For more information, visit ASHCompanies.com or call 1-800-848-3555.



            

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