Court to Managed Care Plans: No More No-Cause Boots

Rose, Joan R., Medical Economics

Managed care plans cannot arbitrarily dismiss physicians from their provider networks, even when the agreedupon contract permits no-cause terminations, the California Supreme Court has ruled. "If participation in managed care arrangements is a practical necessity for physicians generally and if only a handful of health care entities have a virtual monopoly on managed care, removing individual physicians from preferred provider networks controlled by these entities could significantly impair those physicians' practice of medicine," the court reasoned.

The case in question arose in 1992, after ob/gyn Louis E. Potvin was booted from MetLife's provider network. Under the terms of his …

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Publication information: Article title: Court to Managed Care Plans: No More No-Cause Boots. Contributors: Rose, Joan R. - Author. Magazine title: Medical Economics. Volume: 77. Issue: 13 Publication date: July 1, 2000. Page number: 24. © Advanstar Communications, Inc. Jan 23, 2009. Provided by ProQuest LLC. All Rights Reserved.

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