MDs sue health plan on quality ratings

Six Washington doctors and the Washington State Medical Association are suing Regence BlueShield, claiming that the insurer's decision to exclude them from their "select" network due to poor quality is unfounded and damages their reputation. Regence has informed customers that 500 Washington state doctors would no longer be covered by the plan because they provide low quality, inefficient care. The physicians say that the insurer's quality ratings are completely inaccurate and out of date, and are suing for defamation, deceptive business practices and breach of contract.

"At the core of this matter is that true quality improvement programs need the active involvement of physicians to make sure the standards that are applied are fair, accurate and do not unduly interfere with the doctor-patient relationship," Dr. W. Hugh Maloney, the medical association's president, said in a statement. Regence, however, said its quality ranking data is correct and that it wants to work with the state medical association to resolve the problems. Patients are dissatisfied with the insurer's decision because it means many of them have to find new healthcare providers and transfer their medical records.

For more on the lawsuit:
- read this AP report

Post a comment