Doctors, Insurer, Agree to Arbitration

     ATLANTA (CN) – A physicians group and Blue Cross and Blue Shield of Georgia will settle their differences in arbitration rather than litigation, said a Fulton County Superior Court judge. The parties have until April 15, 2009 to complete the non-binding arbitration process in the dispute over reimbursements for cancer treatments.




     Northeast Georgia Cancer Care accused Blue Cross of arbitrarily lowering the reimbursement rates for cancer infusion drugs, services and procedures, in the complaint filed in September. The doctors said they were forced to litigate after the insurer failed to respond to a complaint addressing the 2007 PPO contract and Participating Physician Agreement.
     In response, Blue Cross sought to compel arbitration and to dismiss the complaint or stay proceedings pending arbitration. The insurer claims the doctors circumvented the arbitration process by filing the lawsuit.
     Court proceedings were stayed during arbitration.     
     “We will do our best to resolve this matter in non-binding arbitration,” said Loretta Goodson, practice administrator with Cancer Care.
     Blue Cross spokeswoman Cheryl Monkhouse said, “Once the plaintiffs serve their arbitration demand on BCBSGa, we will proceed to comply with and participate in the arbitration process.”
     In October, the doctors filed an amended complaint to dispute a 2007 HMO contract in addition to the 2007 PPO contract and the Participating Physician Agreement disputed in the first complaint.
     According to the order, only the 2007 PPO contract and the Participating Physician Agreement will be dealt with in arbitration; the doctors are free to file another complaint to only dispute the 2007 HMO contract.
     Goodson said the physicians’ attorneys are working on the new complaint and expect to file it soon.
     The doctors are represented by James W. Boswell with King & Spalding.

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