Keystone Health/South Valley, an independent practice association in Tarzana, Calif., has filed suit against one of its former physicians and his new medical group, charging them with an illegal raid on more than 2,000 Keystone patients.
The suit was filed in Los Angeles Superior Court in Van Nuys against David Abrams, M.D., Beverly Hills (Calif.) Medical Group and its parent, Cedars-Sinai Medical Care Foundation, Los Angeles. It seeks more than $1 million in damages and to halt a practice that illustrates the "feeding frenzy...of organizations vying for capitated lives," said James McCord, Keystone's attorney.
In addition to contractual violations, the suit charges that Abrams, who sold his practice to Cedars-Sinai, sent an announcement to his patients telling them they were required to leave Keystone and choose a medical group in which he participated. Abrams is a member of both Beverly Hills Medical Group and Greater Valley Physician Association, which was mentioned in the suit but is not a defendant. Cedars-Sinai has entered into an agreement to purchase Greater Valley.
The announcement implied that patients had to immediately change the medical group designation on file with their health plan to ensure continuity of care, the suit charges.
Patients were not informed they could remain with Keystone by switching primary-care providers. The announcement referred patients to a telephone number answered by Cedars-Sinai, the suit said.
"We believe the announcement was authored by the people at Cedars prior to (Abrams') resignation from the IPA," McCord said.
Keystone said it believes that more than 2,000 enrollees in health plans contracting with Keystone received the announcement and, as a result, about 1,500 of their capitated patients switched to other medical groups.
The suit seeks financial damages estimated at more than $1 million and a court order requiring Cedars-Sinai to communicate with Keystone's former and current patients to correct the misconceptions caused by Abrams' announcement.
A spokesman for Cedars-Sinai Medical Center said it does not comment on pending litigation>