Friday, June 28, 2002
Major insurance companies sued
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Underpayment tops doctors' claim
By Dan Horn,
[email protected]
The Cincinnati Enquirer
Greater Cincinnati's doctors sued every major health insurance company in the region Thursday, accusing them of conspiring to underpay physicians.
The Academy of Medicine of Cincinnati leveled the charges in two lawsuits it filed on behalf of 1,900 doctors in Cincinnati and Northern Kentucky.
The lawsuits claim that doctors have been forced to quit or leave the Cincinnati area because insurance reimbursement rates here are much lower than in other cities.
The lack of physicians has, in turn, damaged the quality of health care, the lawsuit states.
"The crown jewel of our medical community has been disenfranchised by substandard reimbursements," said Cincinnati lawyer Stan Chesley, who filed the lawsuit. "The consuming public is not getting what they bargained for."
Doctors have complained for several years about the reimbursement they receive for their work from insurance companies. Cincinnati has lost hundreds of doctors in recent years and has lagged other cities in physician recruitment.
The reason, according to the lawsuit, is reimbursement rates that are as much as 50 percent lower in Cincinnati than in nearby cities.
The insurance companies named in the lawsuit include Aetna, Humana, Anthem Blue Cross and Blue Shield and United Health Care of Ohio.
Most company officials could not be reached for comment late Thursday, but many have previously disputed that they underpay doctors in the Cincinnati market.
"Anthem believes in offering fair and competitive reimbursement rates to its doctors, hospitals and other health care providers," Anthem spokesman Joe Bobbey said Thursday.
The lawsuits were filed in Hamilton County Common Pleas Court and Boone County Circuit Court.
They seek unspecified damages and a court order to change the insurance companies' reimbursement policies.
