PROFESSION

Connecticut physicians win round in court against HMO

A state court judge certifies Connecticut doctors as a class in a lawsuit against Anthem; others await a ruling in a federal suit against HMOs.

By Tanya Albert, AMNews staff. Aug. 13, 2001.

A lawsuit against managed care that started with less than a dozen Connecticut orthopedic surgeons suing Anthem Blue Cross Blue Shield of Connecticut now has all physicians in the state as plaintiffs.

A state judge in July classified the surgeons' suit as a class action, making the court among the first in the nation to rule that a large number of doctors have a stake in a suit challenging the way HMOs do business. The state has more than 7,000 physicians.

"We've got major issues, and this is a mechanism for us to get a seat at the table," said Edward Collins, MD, a Willimantic, Conn., orthopedic surgeon and one of the original plaintiffs in the suit. "We're very happy to get class certification. It really does apply to every physician in Connecticut who signed a contract with Anthem."

The Connecticut surgeons filed their suit in late 1999. It accuses Anthem of breach of contract, not acting in good faith, conversion and violation of state unfair trade practices and insurance statutes. The physicians claim the company unilaterally decreases reimbursement and won't authorize some medically necessary treatments or prescription drugs.

Anthem Blue Cross Blue Shield spokesman Clark Dumont said the July ruling was procedural and that it does not address the merits of the physicians' case. Clark also said the judge did not let every charge in the lawsuit go forward as a class action. "We're very proud of our day-to-day collaboration with our providers," Clark said. "We believe we have an excellent network." [...]

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