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Coventry to buy Kansas health plan

Coventry Health Care plans to buy a hospital-owned health plan that will add 120,000 members to its rolls. The acquisition, Preferred Health Systems, is a subsidiary of Via Christi Health System, a Wichita, Kan.-based network of hospitals and nursing homes. Doctors in Wichita are sorry to see a locally owned health plan disappear, but they are trying to withhold judgment about Coventry until they see the company in action, said Joe Davison, MD, a Wichita family physician and president of the Kansas Medical Society. Dr. Davison also is the past president of the Medical Society of Sedgwick County and was speaking on behalf of the county society. "We are not going to start off this new relationship with bad blood," he said. Dr. Davison said physicians in Kansas are historically wary of national health plans. He cited the role the state medical society played in fighting to stop BlueCross BlueShield of Kansas' proposed conversion to a for-profit plan so it could be acquired by ...

Pharmacy groups sue over Medicaid drug cuts

Cuts to Medicaid prescription drug payments in four states could jeopardize patients' access to needed medications, according to separate lawsuits filed by several national and state pharmacy organizations. The National Assn. of Chain Drug Stores, the National Community Pharmacists Assn. and local pharmacy groups allege that the state Medicaid programs are basing their payment rates on artificially low benchmarks for the average wholesale price for various prescription drugs. As a result, many pharmacies are being paid well below the cost of stocking medications and may be forced either to drop their Medicaid contracts or close their doors altogether, according to complaints filed Sept. 29 in separate federal courts in California, Minnesota, New York and Washington. The pharmacy organizations argue that the reductions violate federal laws requiring payment rates be set at sufficient levels to ensure that Medicaid patients have the same access to prescription drugs as patients who ...

Connecticut court opens door for patients to see peer review records

A recent Connecticut Supreme Court decision has chipped away the state's peer review privilege, physicians say. On Aug. 25, the high court ruled that certain peer review protections do not apply to patient requests for related information through the state's Freedom of Information Act. Justices in a split decision said peer review records were protected from disclosure only in court actions. The case was sparked when a physician's former patient sought records from the University of Connecticut Health Center regarding the hospital's decision not to renew the doctor's clinical privileges. Because the hospital was a public institution, the high court found it was subject to the Freedom of Information Act and allowed the patient access to the credentialing records. The ruling not only puts state hospitals at a disadvantage for peer reviews, but it also could affect private facilities if the public is permitted to scrutinize peer review information, said Layne Gakos, the Connectic ...