Physicians File Lawsuit Against BCBS of Michigan Opposing Health Plan Fee Reductions

The Michigan State Medical Society and the Michigan Osteopathic Association have filed a lawsuit in a Lansing, Mich., circuit court against Blue Cross Blue Shield of Michigan challenging planned fee reductions by the health insurer intended to help reduce health costs for U.S. automakers, the Wall Street Journal reports. BCBS of Michigan in September 2004 agreed to a proposal by General Motors, Ford Motor Co. and Daimler Chrysler to eliminate 500 physicians, or about 5% of in-network physicians, from the network of a health plan with about 120,000 autoworker members. An additional 1,900 physicians withdrew from the plan voluntarily when told by BCBS of Michigan that payments for a range of medical services would be reduced. Dan Shulte, an attorney for MSMS, stated that BCBS of Michigan has no contractual right to limit physicians' fees. Shulte said that physicians should have been involved in negotiating their own fees and that the court should prohibit BCBS of Michigan from dismissing doctors who refuse to reduce their fees. Lisa DeMoss, a senior vice president and general counsel for BCBS of Michigan, said the changes were designed to remove "some practitioners with less cost-effective patterns of care" (Hawkins, Wall Street Journal, 2/8).