Massachusetts MS Sues Group Insurance Commission

Armen Hareyan's picture

The Massachusetts Medical Society on Wednesday filed a lawsuit against thestate's Group Insurance Commission, which purchases health insurancefor most state employees and retirees, over its physician ranking system, the AP/BostonHeraldreports (AP/Boston Herald, 5/21). The lawsuit seeks to end theranking system or require the commission to use transparent ranking standards,the Heraldreports. The ranking system has three tiers to categorize doctors based on costand quality measures, and insurers charge patients more to see physicians inthe lower tiers (McConville, Boston Herald, 5/22). The suitalleges that some physicians in the lower tiers have been defamed and thatpatients who contribute higher copayments to see those doctors have beendefrauded, the Boston Globe reports.

Massachusetts Medical Society President Bruce Auerbach said that efforts toimprove the physician ranking program have failed. Auerbach said that the most"glaring problem" with the clinical performance improvementinitiative is that it uses "inaccurate, unreliable and invalid tools anddata." Dolores Mitchell, executive director for GIC, said, "We agreedto a lot of the suggestions" the medical society made, "but not allof them" (Krasner, Boston Globe, 5/22).

The lawsuit also names Tufts HealthCare and UniCare Life and Insurance (Boston Herald, 5/22).

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