Unilateral contract changes: Plan gives Michigan physicians the blues

Doctors are fighting in court against contract terms dictated by the state's Blues plan. A judge should see fit to rule in their favor.

Editorial. March 7, 2005.

There is a lot about managed care that drives physicians crazy. But one of physicians' biggest pet peeves is when a plan changes a contract unilaterally.

At the very least, it's a sign of disrespect. Physicians should be informed of any contract changes so they can get a chance to negotiate them and decide whether they will accept them or not. Then physicians can give their patients in the affected plan ample notice if they decide to drop it.

In Michigan, two medical societies are taking the issue on as a legal matter by leading the fight to stop the state's largest health plan from getting away with what doctors charge is a unilateral change in contract terms. The Michigan State Medical Society and the Michigan Osteopathic Assn. in September 2004 sued Blue Cross Blue Shield of Michigan after the plan threatened to terminate any doctor who failed to accept heavily discounted fees for patients affiliated with a plan set up by the United Auto Workers, General Motors, Ford and DaimlerChrysler.

Some background: In 2003, the Big Three automakers and the UAW, in their collective bargaining agreements, set up a new self-insured health plan to replace the existing one. They hired the Michigan Blues to administer it, doing all the things a third-party administrator does: claims processing, enrollment tracking and record-keeping.