Editorial: A New Skirmish In The Managed Care Wars

A New Skirmish In The Managed Care Wars

A new skirmish in the battle over managed care broke out last month when a New York medical association representing some 27,000 physicians filed a dozen lawsuits against six of the biggest health insurers in the state.

According to published reports in Newsday and The Wall Street Journal, the Medical Society of the State of New York charged the managed care firms with arbitrarily denying medically necessary health care, and wrongly slashing contractual payments to providers. The suits also claim that the insurers have inadequate staffing to deal with the volume of claims they are asked to handle, resulting in unsatisfactory service to providers and patients.

The doctor group also leveled a more qualitative accusation–that the named insurers had wrongly inserted themselves where they had no business being; namely, right in the middle of what one medical society official called the “holy doctor-patient relationship.”

The suits were filed against Aetna, CIGNA, Empire Blue Cross and Blue Shield, Excellus, Oxford, and United Health Group. Six of the suits filed in New York State Supreme Court ask the court to stop the disputed practices of the named managed care firms, while six other class-actions demand unspecified monetary damages.