Early stages of the litigation have extended over the past three years, in which various preliminary legal issues have been argued and decided. In addition to its conditional certification of a class of all physicians who had sought reimbursement from Aetna, the Miami district court also decided that the plaintiffs could proceed with their RICO claim with certain changes to the allegations, and that claims based on provider agreements that included an arbitration clause should be resolved through arbitration instead of in a court. Although the development of the factual underpinnings of the claims is just beginning, one of the defendant MCOs, Aetna, has entered into a settlement agreement with the attorneys representing the physician class representatives. The Agreement includes procedural changes, called "business practice initiatives," that are intended to improve physician-company relations going forward. Some of these initiatives had already been implemented while the parties were discussing settlement.