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Cancer Doctors Sue Blue Cross Again

ATLANTA (CN) - Northeast Georgia Cancer Care has made good on its promise to continue it legal battle with Blue Cross and Blue of Shield of Georgia despite a recent agreement to arbitrate. The doctors accuse the insurer of arbitrarily reducing reimbursement rates for cancer drugs and treatments, in breach of 2007 HMO contracts.

"This action stems directly from defendant's persistent refusal either to abide by the express language of the 2007 HMO contracts or to honor its commitment to deal in good faith with plaintiffs," the doctors say.

A Fulton County Superior Court judge last week ordered the parties to arbitrate a dispute regarding 2007 PPO contract and the Participating Physician Agreement but said the doctors were free to sue again over the 2007 HMO contracts.

The judge gave the parties until April 15, 2009 to complete the nonbinding arbitration process.

The doctors sued over the 2007 PPO contract and the Participating Physician Agreement in September and amended the complaint in October to add the 2007 HMO contract.

In response, Blue Cross sought to compel arbitration and to dismiss or stay proceedings pending arbitration. The insurer says the doctors circumvented arbitration by suing. Court proceedings were stayed during arbitration.

The two parties have a similar lawsuit pending before the Georgia Court of Appeals. This lawsuit, filed in 2007 in Clarke County Superior Court, challenges reimbursement rates for oncology contracts. The dispute caused Blue Cross to drop Cancer Care from its HMO network for medical oncology, according to Loretta Goodson, practice administrator for Cancer Care.

The doctors are represented by James W. Boswell with King & Spalding.

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