Blown apart: A bitter battle between an insurer and doctors

A Buffalo group shuffled off to oblivion in the aftermath of one of the most brutal fights ever between physicians and a health plan.

By Mike Norbut, AMNews staff. March 3, 2003.

The fight between Buffalo, N.Y.-based Promedicus Health Group and the HMO that spawned it is so extreme, the physician group is asking a bankruptcy court to approve a plan to put the physician group out of its misery and let it die.

The Chapter 7 liquidation filing by Promedicus is the most telling sign of a deteriorating relationship between the group and Univera Healthcare since the Buffalo, N.Y.-based plan decided to convert from a staff-model HMO to a managed care plan without physician employees.

The battle has hit the public eye with the force of a Lake Erie blizzard. It has included lawsuits from both sides and dueling newspaper ads -- Univera accusing doctors of patient abandonment and professional misconduct, and physicians alleging a "secret" limited referral network. The treatment of Promedicus' physicians by the Buffalo area's third-largest health plan has stunned doctors outside the group, who certainly are no strangers themselves to disputes with health plans.

"I have never seen anything like this," said Nancy Nielsen, MD, PhD, a Buffalo internist and vice speaker of the AMA House of Delegates. "I think it's outrageous."

However, what Univera thinks is outrageous is what it sees as Promedicus' attempt to use the U.S. Bankruptcy Court to allow the group to break its contracts and allow physicians to start new practices without hassles.

"We will do anything and everything necessary in the legal process to protect our members and our business," said Arthur R. Goshin, MD, CEO of Univera and Lifetime Health Centers, six clinics where Promedicus physicians practiced. "And we want to make sure [the physicians] meet their professional obligations."