State supreme court rules doctor termination illegal
July 1, 2000 less than 1 minute read
State supreme court rules doctor termination illegal
The California Supreme Court has upheld an appeals court’s decision that an insurer can not drop a physician from its provider network without a fair review process, despite a "without cause" termination clause in the provider’s contract.
According to the court, this so-called "fair procedure doctrine" is activated when an "insurer possesses a power so substantial that the removal significantly impairs the ability of an ordinary, competent physician to practice medicine in a medical subspecialty in a particular geographic area, thereby affecting an important, substantial economic interest."
(See Potvin v. Metropolitan Life Ins. Co., No. S061945, Cal., May 8, 2000.)
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