Aetna U.S. Healthcare, the country’s largest HMO, has been hit with a class-action racketeering suit by a group of consumers who say it lured them in with false promises of high quality care while secretly pressuring doctors to cut costs and provide only minimum care.

The suit, filed in U.S. District Court in Philadelphia, says Aetna marketed its HMO with false promises that its “primary commitment” was to maintain and improve the quality of care. In reality, the suit alleges, Aetna is “primarily driven by fiscal and administrative considerations implemented through defendants’ undisclosed systematic internal policies which result in the reduction of the quality of the healthcare services provided to plaintiffs and the class.”