A contract fight between a group of Georgia physicians and BlueCross BlueShield of Georgia has erupted into a much-larger dispute over state rules on who plans must admit to their physician networks. Doctors with Northeast Georgia Cancer Care sued the Blue plan after being told that its medical oncology network was closed, then finding out that it gave an exclusive HMO contract to another cancer group for Northeast's market. The move pushed the medical oncologists out of the HMO network, forcing 100 of the group's patients to change doctors, group executives said.
The cancer doctors' suit contends that the HMO's move is illegal under the state's any-willing-provider statute, which generally requires health plans to open their doors to any provider who accepts their terms and meets their standards. Their challenge won the support of the Medical Association of Georgia, which has filed a friend-of-the-court brief arguing in favor of the cancer physicians' position. The Blue plan, meanwhile, argues that the any-willing-provider law doesn't apply to HMOs, and is asking the judge the throw the case out of court.
To learn more about the case:
- read this AMNews piece
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