Saturday, November 11, 2006

Physician group sues insurance company for defamation

According to an article in the November 1, 2006 of Internal medicine News (www.internalmedicine.com) six Washington state physicians and the Washington State Medical Association have filed a suit against Regence Blue Shield. This insurance company notified some 500 physicians that they did not meet the "standards" and were dropped from the network. But they went further- they then contacted 8,000 of those physicians' current patients and informed them that the docs did not meet quality standards basically claiming they did not practice quality medicine.

Attacks on professional integrity or on a professional person's integrity in some jurisdictions may be considered "per se" defamation. I had written before about the Washington state situation and wondered then if there might be a case of legal action and it looks like there may be and I applaud the Washington docs for taking action doing what they can to protect their rights and level the playing field .Other state medical associations have had some success in battling the big insurers, witness the Texas Medical Association action against several large HMOs under RICO.

The lawsuit claims deceptive trade practices,breach of contract and defamation.

Dr. Gail Wilensky (Ph.D) was also quoted in the article as she continues to play the strings of the support-P4P effort and supported the position of the insurance company saying in part "All data has errors but that doesn't mean the suggested conclusions are faulty "

Dr. Wilensky is often described in news articles as a senior fellow at Project HOPE and a member of the Institute of Medicine panel [onP4P]. Often not mentioned is the fact she is on the board of Unitedhealth Group,holds about $800,000 worth of UNH stock or that she cashed in 1.3 million dollars in UNH options in 2005. (information from Yahoo finance as of 11/11/06).

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