An HMO had no right to fire a surgeon without telling him why, the New Hampshire Supreme Court ruled last week.
The high court overturned a lower court's decision that Paul Harper, M.D., of Derry, N.H., could be fired by Healthsource New Hampshire without cause. The justices unanimously ruled that Harper's relationship with Healthsource New Hampshire affects the public interest, and therefore Healthsource must give a reason for the firing.
"We're very pleased," said Harper's lawyer, Stanton Tefft of Bedford. "This basically says an HMO can't control what a doctor does."
Harper, a doctor for more than 20 years, claims Healthsource unfairly fired him in 1989 after he discovered the company allegedly manipulated patient treatment records.
After Harper told Healthsource he was concerned about the changes to patient records, Healthsource informed Harper it was terminating his contract because he had not satisfied its "recredentialing criteria."
Harper appealed, requesting copies of whatever documentation Healthsource relied upon to make its decision, but Healthsource refused to provide the requested material.
Harper appealed again, and Healthsource ruled it was firing Harper without cause.
In his argument to the Supreme Court, Harper argued that firing him without cause is against public policy. The high court agreed.
"We conclude that the public interest and fundamental fairness demand that a health maintenance organization's decision to terminate its relationship with a particular physician provider must comport with the covenant of good faith and fair dealing and may not be made for a reason that is contrary to public policy," the justices ruled.
The high court, however, affirmed a lower court's decision that Harper did not deserve equal protection and due process. Harper argued that Healthsource was acting as a representative of the state because its client base covered welfare recipients and state workers.
Tefft said he was satisfied with the court ruling because his focus was to prove Healthsource had no right to fire his client without showing why.
"An HMO cannot arbitrarily and capriciously say to a doctor, `You're done,' " Tefft said. "If an HMO can dismiss you without cause and you can't do anything about it, you're dead."