Blue Shield wins lawsuit over doctor rankings

Blue Shield of California doesn't have to shut down its online doctor ranking system because a judge ruled that it is a form of protected speech.

The California Medical Association last year sued Blue Shield over its Blue Ribbon Recognition Program, which launched in June and posted blue ribbons on its website next to the names of doctors who met national standards for quality care, reports the Los Angeles Times.

CMA wanted the rating system shut down because it said Blue Shield failed to consider information from patient medical charts, outcomes and previous treatment when determining the rankings. CMA also alleged that Blue Shield gives the blue ribbons to physicians who cost the insurer less per visit than other physicians cost, reports National Underwriter. As such, CMA said the rating system is inaccurate, misleads consumers and attempts to "economically profile" doctors, according to California Watch.

However, Judge Steven Brick dismissed the suit outright, ruling that the Blue Ribbon program is a form of "protected consumer information." Plus, CMA failed to demonstrate that they suffered a loss of business or other harm because of the Blue Ribbon program and failed to show how the program impeded its own activities. There also has been no evidence that "a Blue Shield member or member of the public has relied upon the Blue Ribbons for any purpose, let alone that such reliance caused plaintiffs to incur harm," Brick says, notes National Underwriter.

Michael-Anne Browne, Blue Shield's medical director for quality, called the dismissal "a validation that Blue Shield has every right to recognize high-performing physicians through its Blue Ribbon Physician Recognition Program, and that none of the claims asserted by the CMA had legal merit."

Blue Shield plans to continually update information to use in its Blue Ribbon initiative to provide "unbiased healthcare quality information drawn from nationally recognized, industry-standard measures of processes and dimensions of care," Blue Shield spokesperson Johnny Wong told FierceHealthPayer.

CMA's director of litigation Long Do said the ruling was disappointing because the doctors group never got to argue that the Blue Shield data was problematic. "We filed this because we believed Blue Shield was using flawed data, and by doing that, they were potentially misleading the public," he said. CMA is still deciding whether to appeal the ruling, notes California Watch.

To learn more:
- read the Los Angeles Times story
- view the National Underwriter article
- see the California Watch blog

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