Regence sued over exclusion of doctors
Published 9:00 pm Thursday, September 21, 2006
SEATTLE – The Washington State Medical Association sued Regence BlueShield on Thursday, accusing the health insurer of using flawed methods and outdated information to exclude more than 500 doctors from a “select” network.
In a lawsuit filed in King County Superior Court, the medical association accused Regence of defaming doctors in letters to thousands of patients, telling them their physicians lacked “quality and efficiency in their practices” and would not be covered under the new network.
The lawsuit seeks to block Regence from implementing the select network, saying it was based on “statistically flawed data and methodology that mischaracterized physicians’ practices.”
Regence defended its methods of collecting data and said it’s working with the medical association to address its concerns.
“We have been working with them and have been taking their feedback into consideration,” Regence spokeswoman Angela Hult said.
Regence created its select network at the request of Boeing Co., the state’s largest private employer, which said it wanted a new plan that set criteria for measuring quality and controlling costs.
After an outcry from its engineers union, Boeing told about 18,000 Seattle-area employees two months ago it would not be offering the new plan until July 2007 – a year later than initially scheduled – and said it would work with Regence on changes that would address concerns raised by doctors and its employees.
The association, which represents more than 9,000 doctors in Washington, questioned Regence’s choice to analyze only insurance claims rather than also reviewing medical records.
