BUSINESSBuffalo HMO network drops physicians it battled withMembers of Univera Healthcare in New York have received letters telling them services provided by former Promedicus doctors will no longer be covered.By Mike Norbut, AMNews staff. June 16, 2003. In the latest chapter of the battle between a Buffalo, N.Y., HMO and a bankrupt physician group, Univera Healthcare has dropped 32 former Promedicus Health Group physicians from its network, telling members they will not be covered for services if they see those physicians after June 27. The physicians make up eight practices that have formed since Promedicus filed for Chapter 7 bankruptcy Jan. 8. Many used to staff Univera-owned Lifetime Health Centers on a contractual basis, and some even date back to the HMO's staff model days, when physicians worked in the centers as employees before breaking off with the HMO's consent to form their own group in 1997. Univera's letter to patients lists the primary care physicians and ob-gyns in question, and says they are not currently participating with the HMO network. The letter offers coverage exceptions to pregnant women who have entered their second trimester or patients who are receiving ongoing treatment for acute illnesses. Univera's position is that, even though it did not have a contractual arrangement with the new practices, it continued to pay for services by former Promedicus physicians for a 90-day period after the group's Chapter 7 liquidation filing, during which the bankruptcy trustee could have extended the Promedicus contract. The letter to patients was a result of the 90-day window closing without an extension. Physicians, however, say they were led to believe they had been accepted into the network. Lisa Hoffman, MD, an internist and president of the 11-physician Southgate Medical Group, said Univera representatives conducted a site visit within the last few months and had granted billing numbers for her practice. [...]Full text of AMNews content is available to AMA members and paid subscribers.
Copyright 2003 American Medical Association. All rights reserved.
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