Saturday, December 31, 2011

Blue Cross and Blue Shield of North Carolina responds to suit by Huntersville doctor - Kansas City Business Journal:

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The N.C. insurer and its codefendants deny claimsaby Dr. John Powderly II in a $20 millionn lawsuit. Powderly claims the insurers kept him outtheifr physicians' network to avoid paying for high-cost treatment for canceer patients. Also named as defendants are Blue Crossand , the and Healtn Care Services is the parent for several Blue Cross organizations. The while differing in some details, are The insurers contend they have committed noantitrusrt violations. And they deny Powderly'z contention that as the dominant insurers intheir regions, the groupw exercise monopoly power over health-carre payments. The N.C.
organization says Powderly is tryinv to force Blue Cross to deal with hispracticed -- -- on his terms rather than the Blue Cross of North Carolina says Powderly's grouop administers Phase I clinical trials and those trials involvse initial testing for unapprove drugs. Blue Cross says it is not required to provide coverages forthose trials. It does, the insurer says, provid coverage for later-phase clinical trials involvingbapproved drugs. Blue Cross says it denied Powderly "in-network status" solely because of those Phase I It denies there is any conspiracy or other motivr behindthe decisions.
All the insurers also contend the case wouldd be more appropriately heardf in a Florida federal court that is close to approving a negotiated settlementof class-action antitrust accusations against Blue Cross organizations. The groupa attempted to transfer Powderly's case to that court and asked U.S. Districft Court Judge Frank Whitney to stay actions in the case pendinvthat transfer. Whitney refused. The federalk panel that assignssuch class-action casesz has since declined to move Powderly's But the groups still have motionz pending in the Florida federal court that ask the judgse to declare Powderly's case a violation of his class-actionj order.
No hearings have yet been set in Powderly'e case here or in

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