Georgia doctors sue for access to United's contracts with state plan

Appeals have been filed asking the state Supreme Court to determine whether some documents should be treated as public records or exempted as trade secrets.

By Amy Lynn Sorrel, AMNews staff. Aug. 11, 2008.

When the South Georgia Physicians Assn. LLC noticed that the health insurer administering Georgia's state employee health benefits plan was requiring different contract terms for rural doctors than for those in urban areas, the group got suspicious.

The Georgia Dept. of Community Health in 2005 awarded United Healthcare a five-year, $55 million contract to service the state-funded plan. It took effect Jan. 1, 2006.

While the insurer was recruiting doctors to participate in the plan, John Crew, a consultant who assists practices in health plan contract negotiations, saw as many as six different versions with varying fee schedules offering lower reimbursement to rural doctors, he said. At one point, United also put all-products clauses in some contracts, added Crew, who works with South Georgia Physicians. The independent practice association has about 280 physician members practicing in about 30 counties in predominantly rural southern Georgia.

"When the state enters into a vendor relationship, doctors ought to be able to participate on equal terms to other providers and should not be disadvantaged by where they are located," Crew said.

The physician group, joined by the Medical Assn. of Georgia, filed an open records request in March 2006 asking United and the health department for documents related to the state contract. Under state law, records maintained by a private entity performing a service on a government agency's behalf are subject to public disclosure. The medical association and physician group asked for fee schedules, executed physician and hospital contracts, template physician contracts, and any correspondence between United and the state health department.