PROFESSIONPhysician feedback encouraged as health plan settlement shakes outIf you don't think CIGNA and Aetna are living up to their lawsuit settlement agreements, here's what you need to do to report problems.By Tanya Albert, amednews staff. July 26, 2004. Physicians, medical societies and lawyers who hammered out agreements with Aetna and CIGNA that will change the way the health plan giants handle physician claims have no reason to believe the changes won't go as promised. But they aren't taking any chances. The 40 medical societies that signed on to each agreement will help in making sure that the companies follow the settlement agreements and change their business practices. "It's one of those trust-but-verify situations," said Connecticut State Medical Society Executive Director Timothy B. Norbeck. CSMS is one of the original medical societies to sue Aetna and CIGNA over the way they paid physicians. The Medical Assn. of Georgia, Texas Medical Assn., California Medical Assn. and more than a dozen other medical societies also were part of the original lawsuits. But lawyers and organized medicine leaders said grassroots physicians also need to be alert for problems and report them so that the agreements are more than words on paper. The settlements cover an estimated 900,000 active and retired doctors. "These documents are just hundreds of pages of legalese unless they are enforced," said Deborah Winegard, MAG's general counsel. "Sitting in my office here at MAG, I don't know what is going on in the doctors' offices." Texas Medical Assn. President Bohn Allen, MD, agrees that individual physicians raising concerns will be what holds the health plans' feet to the fire. And he is encouraged that the Miami federal court that approved the settlements will continue to be involved in enforcing them for four years. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2004 American Medical Association. All rights reserved.
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