California Doctor Files Suit Against Blue Cross for Denying His Application To Become Part of Their Network After Agreeing to Th
Posted Sep 30 2010 10:40pm
“Any Willing Provider” law in California is where the doctor is contesting the fact that they won’t let him in, after agreeing to all terms and payments and meeting provider eligibility criteria. This goes back to the early HMO days where only a certain number were allowed to participate and perhaps they are up to that number if this is still being practiced?
The doctor has formerly been an approved provider and there’s not any additional details here as far as any other reasons that may enter the picture for the decision so stay tuned. BD
LOS ANGELES – A California doctor has filed a lawsuit against Anthem Blue Cross for allegedly denying his application to become a part of the company’s provider network, an action the lawsuit contends violates California’s “Any Willing Provider” law.
The lawsuit seeks to enjoin Blue Cross from preventing any physician who is willing to accept the terms of Blue Cross contracts and meets Blue Cross' eligibility criteria from becoming a Blue Cross provider.
The legal action revives an issue that was contested numerous times in the early 2000s, when HMOs and MCOs had established a practice of limiting the number of doctors in their provider networks as a cost-saving measure, and could bring back into focus individual states’ rights surrounding insurance regulation.