The Massachusetts Medical Society has filed a lawsuit challenging the physician-ranking program used by the governmental agency that purchases health insurance for state employees and retirees.
The complaint, filed in Suffolk County Superior Court in Boston, seeks to halt or change the tiering program, called the Clinical Performance Improvement Initiative, which the medical society alleges harms and defrauds patients and physicians. More than 294,000 people are enrolled in health plans administered by the Commonwealth of Massachusetts Group Insurance Commission, a quasi-independent state agency overseen by an 11-member body with a $1.75 billion annual budget.
This year, the CPI has been extended to more physicians and specialties, affecting more patients than ever, Bruce Auerbach, president of the Massachusetts Medical Society, said in a written statement. More physicians are in lower tiers because they were assigned costs from patients they did not treat, and for procedures they did not perform. This is misleading and simply not fair.
Dolores Mitchell, executive director of the Massachusetts Group Insurance Commission, called the lawsuit regrettable, adding that the agency had sought the medical society's recommendation on the 2-year-old programs design. -- by Rebecca Vesely