HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that major Kansas City-area payors have been named as defendants in four class-action lawsuits filed by a number of provider groups. According to the latest issue of the Kansas & Missouri Health Plan Analysis, the 25 medical groups claim the payors conspired to fix doctors' reimbursement at unacceptably low rates.
Those named in the lawsuit include Blue Cross and Blue Shield of Kansas City, Coventry Health Care of Kansas Inc., UnitedHealthcare of the Midwest, Aetna Inc., CIGNA Healthcare of Kansas/Missouri Inc. and Humana Inc.
"As evidence, the plaintiffs cite a study they commissioned that shows reimbursement rates for identical services in nearby cities like Wichita and Des Moines are 30% higher or more," said Rick Byrne, HealthLeaders-InterStudy analyst. "But another survey from 2004 found that Kansas City's reimbursement rates fell in the middle of a larger group of cities, including Dallas, Indianapolis, Denver and St. Louis."
Other health plan news in Kansas and Missouri: * UnitedHealthcare is being criticized for the way it enacted its high- quality provider program called Performance in St. Louis and other markets. * Blue Cross and Blue Shield of Kansas has added a health savings account to its plan lineup. * Humana Inc. and UnitedHealthcare have both begun local Medicare PPOs. Humana's is near Kansas City while United's is in Wichita. About HealthLeaders-InterStudy
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