The CEO of a California hospital owned by Tenet Healthcare Corp. says he will personally file a defamation lawsuit for purported comments by Blue Cross of California regarding heart surgeries at the hospital.
A spokesperson for Tim Joslin, CEO of Doctors Medical Center of Modesto, Calif., says Joslin plans to sue Blue Cross, Blue Cross parent company WellPoint Health Networks and research firm Health Benchmarks.
Joslin canceled a press conference scheduled for this afternoon and delayed filing legal action so he could tend to a sick child at home, according to spokesperson Sean Nichols, who is based in Washington, D.C. Nichols says Joslin likely will not sue until after the Thanksgiving holiday.
Doctors Medical Center is not involved in the forthcoming litigation, Nichols says.
In a Nov. 4 filing with the Securities and Exchange Commission, Santa Barbara, Calif.-based Tenet says Blue Cross will terminate its contract with Doctors Medical Center on Nov. 30. Tenet says Blue Cross relies on a study that shows that more than half of coronary artery bypass grafts performed at the hospital over a 37-month period were medically unnecessary.
Tenet also says that Blue Cross owes the hospital $50 million in unpaid claims.
Nichols says an investigation by Doctors Medical Center and the California Hospital Association showed the surgeries were in fact medically necessary and that "Blue Cross admitted it was wrong."
WellPoint spokesperson Michael Chee says the Thousand Oaks, Calif.-based parent of Blue Cross never retracted any statement.
"We are in possession of a report that remains confidential at this time," Chee says. "Details have never been released and we have never rescinded any part of that report."
Chee has no comment regarding Joslin's plans to sue.
Doctors Medical Center is the second Tenet hospital in California to come under recent scrutiny for the medical necessity of CABG procedures. In August, Tenet agreed to pay $54 million to settle federal and state allegations that a facility in Redding, Calif., performed unnecessary cardiac surgeries.