Sue physical therapists Anthem
Bangor, Maine - At least a hundred Maine physical therapists have come together in a class action filed an appeal against the state’s largest health insurance company, Anthem Blue Cross and Blue Shield of Maine, according to lawyer the complainant. The complaint alleges that the State violates the agreements Anthem rules by the precipitous decline in its payments to physical therapists, with its dominant market position under pressure from suppliers to the adoption of less repayments.
A spokesman for the insurance company said Tuesday that the case is without merit.
Lawyer Gregor Brodek Bangor said Tuesday that the case stems from annonce’s Anthem in 2006, 25 per cent to 35 per cent discount on fees for physical therapists. The message came to physical therapists already agreed to reduce their costs to continue to offer their services Anthem’s a lot of insurance, he said.
The case was last summer in Penobscot County Superior Court in Bangor, then on the newly-established enterprises, Maine Business and Consumer Court of Justice. It was recently approved by the court to move forward.
Since low-paid, public programs as Medicare and Medicaid and make a big part of the Maine Insurance, said Brodek, public health professionals have little choice when it comes to transactions with Anthem, which represents the largest portion of private insurance in Maine and a quasi-monopoly on individuals and small groups. The company, headquartered in Indianapolis, writes 68 percent of youth policy group and more than 85 per cent of different areas in Maine.
The “unilateral” reduction of costs of precaution is not well with physical therapists, Brodek said.
“Anthem says:” If you do not like it, please let us know and we will stop all our contracts, “said Brodek. Anthem Given that the supplier would have left the network with a physical therapist exhausted customer base, said he, and also severely limit patients’ access to physical therapy.
“Anthem made, it is 8000 pounds gorilla,” said Brodek. “And we believe that it runs afoul of antitrust rules.” Brodek specializes in competition law and said he has 12 cases pending against insurers in other countries.
Anthem spokesman Mark Ishkanian said Tuesday that “in 2006, changed its anthem costs physical therapists.
We believe that the changes were made in full compliance with the terms of contracts with our partners and the laws of the State of Maine. We believe that the complaint is without merit and will vigorously defend against this suit. ”
The costume must refund payments retroactive to the arrivals physical therapists-2006 before the reduction, as well as damages and legal fees could amount to millions of dollars, after Brodek. More than 100 physical therapists are the suit.
Mila Kofman, Superintendent of the Maine Bureau of Insurance, said Tuesday that his agency has no regulatory authority over insurers’ contracts with providers of medical services. But if the network of physical therapists has been reduced by Significantly, she said, the state “would take a good look hard to risk.
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