For the last few years, a group of physicians has been working to force the health insurer administering Georgia's state employee health benefits plan to disclose what it pays physicians around the state, as well as language found in its physician and hospital contacts. While the doctors assert that such details should be public--given state open records laws--United continues to insist that such details are proprietary. Now, it appears that the state Supreme Court will get to decide whether the group will get its wish.
In 2005, United Healthcare got a five-year, $55 million contract to service the state's self-funded plan. The medical group, the South Georgia Physicians Assn. LLC, later became aware that United Healthcare was paying different fee schedules to physicians in different parts of the state. South Georgia Physicians, an IPA, has about 280 physician members that practice in about 30 counties that are largely rural.
Southern Georgia Physicians, in cooperation with the Medical Association of Georgia, filed an open records request in early 2006 asking for documents related to the state contract in an effort to see whether it was being paid fairly. The request relied on state law requiring that private entities working on a government agency's behalf be subject to public disclosure. However, United contended that the contracts and schedules South Georgia wanted were trade secrets.
The two battled back and forth until they reached the Georgia Court of Appeals, which said that doctors should get at least the records United had already turned over to the state. Now, both have filed an appeal with the state Supreme Court.
To learn more about the case:
- read this AMNews article
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