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Docs Dun HMOs
Aetna/US Healthcare
tops list of Fairfield physicians' ‘deadbeats'
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Business New Haven
4/20/1998
By: BNH
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At any given time, “deadbeat” HMOs owe Fairfield County physicians between $42 million and $60 million for back claims, and the amount is considerably greater if an interest penalty is added.
That's what the Trumbull-based Fairfield County Medical Association (FCMA) says, adding that the situation is forcing many doctors to consider dropping out of the worst offending HMO plans.
“The situation is absolutely critical,” says Bridgeport oncologist Sayed H. Aleali, the FCMA's president. “Several of the largest medical groups in Fairfield County are owed hundreds of thousands of dollars by HMOs for claims that are older than 60 days.
“The impact of being owed so much money is even more devastating for the solo practitioner and smaller groups which typically don't have the reserves to pay the rent, meet payroll and pay the bill,” adds Aleali.
A survey by the physicians group, which represents some 2,000 doctors, found that Aetna/US Healthcare was slowest to pay, owing group doctors almost $10 million in January and February of this year. The next-worst offenders were Physicians Health Services and Oxford Health Plans Inc., which the group says owed doctors some $8.5 million and $8.25 million, respectively.
Earlier this year the group sought legislative relief in the form of a bill establishing an enforceable mechanism compelling HMOs to reimburse physician claims in a “timely” manner. However, the bill was never voted out of the legislature's Insurance & Real Estate Committee.
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