A dozen Georgia physicians have filed a suit against three private HMOs--Peach State Health Plan, AMGP Georgia Managed Care Company and Wellcare of Georgia--claiming that the plans owe millions of dollars in Medicaid reimbursements [1]to doctors, hospitals and other providers. The providers allege that the HMOs knew before they bid on a $3 billion state contract that they'd be unable to reimburse physicians. Because the HMOs haven't paid them, the doctors say they've had to cut down on the number of indigent patients they accept. "These are doctors who have made a commitment to treat the less fortunate, and a substantial percentage of their patients are Medicaid patients," the plaintiff's lawyer, Rod Edmond, told the Atlanta Journal-Constitution. "And if they are owed $50,000 or $75,000 in outstanding claims, it could literally put them out of business." The physicians hope their suit will receive class-action status and that other providers across the state will join them.
To get more background on the suit:
- check out this report [2] from the Atlanta Journal-Constitution for details
Links:
[1] http://fiercehealthcare.com/story/mds-in-ga-missing-medicaid-reimbursements/2006-08-11
[2] http://www.ajc.com/metro/content/metro/stories/0816metdoctor.html