FOR IMMEDIATE RELEASE:
June 20, 2002

FOR INFORMATION CONTACT:
Kelley Elwood, 312-580-6497
                  cell 312-608-3620

                 

Illinois State Medical Society to Back
Lawsuits Against Insurers, Health
Plans; Announces Active Support for
Cases Pending Against CIGNA,
Healthlink & Blue Cross Blue Shield of Illinois.

Chicago, IL – The Illinois State Medical Society today announced its active support of lawsuits pending against several Illinois health plans, as a further escalation of its advocacy efforts on behalf of the state's physicians and patients. The specific class action cases for which the Society today declared its backing are spearheaded by ISMS member Dr. Timothy Kaiser, and involve physicians throughout Illinois and across the nation. Filed as separate actions in Madison County circuit court against CIGNA, Blue Cross Blue Shield of Illinois and Healthlink, the suits allege these insurers' claims-handling policies and practices are in direct conflict with the contracts they signed with physicians and other health providers

"On behalf of our 15,000 members statewide, ISMS will lend our full and active support to Dr. Kaiser and his attorneys, including assistance with fact-finding and case development, as well as identifying new potential cases," said Dr. Ronald Ruecker, ISMS president. "There's a strong and growing body of evidence that insurers' routine business practices breach the agreements they sign with Illinois physicians. We believe this litigation has the potential to correct such abuses, as well as bring sunshine into insurers' cryptic and confusing business practices."

By mutual agreement with Dr. Kaiser and his legal advocates, ISMS will not become a formal party to the cases, due to an assessment that this could slow their progress. "We will, however, work hand-in-hand with them to maximize prospects for success," Dr. Ruecker noted. The attached fact sheet summarizes key points of the litigation.

Over the last decade, Illinois physicians have tried to work out conflicts with various payors over confusing and inequitable policies and procedures. "We've met with them, presented them with examples and even drafted legislation, all to no avail," said Dr. Ruecker. "They've virtually locked physicians and patients out of all the important decisions. Most recently, they've refused to negotiate – or even discuss – problems cited in the Society's fairness in health services contracting legislation. "If we had basic fairness, lawsuits wouldn't be necessary. But we don't, so they are."

Despite this action, ISMS retains its wholly separate, strong commitment to achieving tort reform, which would apply across-the-board to doctors, health plans, businesses and the citizenry at large. "At our most basic, physicians are great believers in fairness and playing by the rules, be it in the courtroom or in our dealings with health plans," noted Dr. Ruecker.

ISMS involvement in the civil lawsuit arena complements its ongoing legislative initiative on contract fairness (HB 6032 and SB 1848), now before the General Assembly. "Our goal is to use a variety of strategies to catalyze change in the current environment. We are not interested in being destructive to managed care or insurance," said Dr. Ruecker. If successful, this litigation will restore physician and patient confidence that the system works fairly for all parties, and that insurance contracts are meaningful agreements based on clear, mutual understanding. Patients will then have a full appreciation of the medical services to which they're entitled, and doctors will know the contract parameters under which they are working."

The Illinois State Medical Society represents over 15,000 physicians statewide practicing in all specialties.

Dr. Ruecker is a board-certified internist specializing in gastroenterology. He practices
in Decatur, IL.