Doctors dispute Blues discount

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Michigan doctors want protection from being terminated from Blue Cross Blue Shield of Michigan insurance plans while a judge decides whether the insurer wrongly set fixed prices for autoworkers’ office visits.

The Michigan State Medical Society and the Michigan Osteopathic Association filed a motion Tuesday in Ingham Circuit Court to prevent Blue Cross from terminating contracts with doctors who don’t accept the discounted fees.

"We feel unsure that physicians will keep their standing before all of this is resolved in court,” said Julie Novak, director of medical economics for the Michigan State Medical Society. “We’re suing Blue Cross because they have a contract with physicians.”

Blue Cross spokesman Helen Stojic said she couldn’t comment about under what circumstances Blue Cross would terminate a doctor’s contract. “We’ll have to leave that to the courts,” she said.

The doctors’ groups sued Blue Cross last September, claiming the insurer wrongly promised autoworkers reduced rates for doctor visits. The fees were negotiated during 2003 contract talks between the UAW and General Motors Corp., Ford Motor Co. and DaimlerChrysler AG’s Chrysler Group.

The doctors are asking the court to rule that they are not obligated to accept the reduced fee, and to prevent Blue Cross from terminating contracts with physicians who refuse the lower fee.

If the suit is successful, doctors will retain control of fees, but patients will pay more.

For Chrysler workers, the reduced fee cuts an office visit from $80 to $60, according to David Fox, a spokesman for the Michigan State Medical Society.

Under the new health care plans, automakers won the right to send workers to a limited number of doctors in a preferred provider network, called a PPO, which helps them better manage health care costs. In exchange, autoworkers pay reduced co-pays for office visits.

Detroit News Staff Writer Eric Mayne

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