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Appeals Court Clears Way for Physician Lawsuit Against MCO

Posted Oct 01 2008 5:07pm

Under a recent decision by the U.S. Court of Appeals for the 11th Circuit, a case brought by a group of physicians against a PPO discount card company and a managed care company for appropriation of the doctors’ names and identities in connection with a plan to market and sell medical discount cards will be permitted to proceed in court. Specifically, the plaintiff physicians have alleged that Private Health Care Systems allowed the Capella Group, Inc. to access the PHCS network including the discounts negotiated with the physicians in the network, as well as their names, professional identities and practice information in order to sell Capella’s medical discount cards.

The physicians allege that PHCS gave Capella access to their information without the physicians’ consent. Originally the federal district court dismissed the complaint, holding that the doctors’ sole remedy was on the contract they entered into with PHCS. However, the Court of Appeals found the district court’s decision to be contrary to Georgia law and reversed the decision, clearing the way for the case to proceed to court on its merits.

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