How does this whole contract thing work...confusion, class action legal cases...does it help to fine the insurers? United recently has come out and said they were going to be "nicer and easier to deal with"...how does a physician have time to keep up with all the contracts and evaluate...waters are still a bit muddy here it appears....BD
2005, a year after UnitedHealthcare acquired Oxford Health Plans, it issued an ultimatum to New York-area physicians: take both plans or you can't participate in either. Internist Daniel L. Brook of New York City, who says he'd had problems with Oxford and didn't want to add another managed care plan, refused to sign with United. As a result, when his Oxford contract expired in October 2005, it wasn't renewed.
United has also been pushing its all-products agenda in other parts of the country. In Texas, for example, it tried to force the members of the Genesis Physicians Group, a 1,740-doctor IPA, to accept an all-products clause, according to Genesis CEO Ron Lutz. But the insurer stopped those efforts, Lutz says, after the IPA reminded United that a former Texas attorney general had declared such contract provisions illegal in the state......"If physicians remained with United, it was not because they favored or liked the plan. We contend they were coerced because of the insurer's market power. They couldn't afford to lose a substantial patient base. Also, many doctors felt they had an obligation to stay in the plan because their patients relied on them."
In California, physicians who want to participate in the PPO plans of United or PacifiCare, which United acquired in 2005, must sign a joint contract with both companies, according to the California Medical Association (CMA). Those physicians who are already in the PacifiCare network can remain in it without signing the joint contract; but they're considered part of the United network, and United members may see those doctors, the CMA says. United declined to comment on any of the points raised in this article. Aetna says it currently has no all-products provisions in California or anywhere else. After CMA challenged Aetna through the compliance dispute process set up by the court, she says, the plan became more compliant with the settlement provisions. Blue Cross of California still hasn't sent physicians revised contracts, and its existing agreements include a provision that requires physicians to treat patients with work-related illnesses or injuries,
Health plans: All or nothing could be here to stay - Medical Economics
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