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Dismissal of Dentists' Fraud Case Against Managed Care Plans Affirmed

By FindLaw Staff on May 14, 2010 | Last updated on March 21, 2019

Am. Dental Assn. v. Cigna Corp., No. 09-12033, involved an action by dentists against managed care plans alleging that defendants engaged in a fraudulent scheme to reduce payments to plaintiffs.  The court of appeals affirmed the dismissal of the complaint, on the grounds that 1) plaintiffs did not point to a single specific misrepresentation by defendants regarding how plaintiffs would be compensated in any of the challenged communications, nor did they allege the manner in which they were misled by the documents; and 2) the allegations in plaintiffs' complaint did not support an inference of an agreement to the overall objective of the conspiracy or an agreement to commit the predicate acts.

As the court wrote:  "The question presented in this appeal is whether, under Fed. R. Civ. P. 9(b) and the pleading standard recently articulated by the Supreme Court in Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 127 S. Ct. 1955 (2007) and Ashcroft v. Iqbal, __ U.S. __, 129 S. Ct. 1937 (2009), Plaintiffs/Appellants ("Plaintiffs") have sufficiently pled factual allegations in their RICO complaint to survive a motion to dismiss. After reviewing the briefs and record and having the benefit of oral argument, we affirm the district court order dismissing the complaint."

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