Georgia health system limits review of contracts

Georgia's largest managed health care organization, Promina Health System Inc., has attracted the concern of some of its contracted physicians and the suspicion of the American Medical Association (AMA), according to an article in AMA News.

Under a policy adopted in January, Promina, which negotiates contracts for 1,800 physicians in the greater Atlanta area associated with the 14-hospital system, is holding 23 managed care contracts under lock and key.

Physicians denied copies of contracts

Though Promina refuses to give to physicians copies of the contracts it has signed on their behalf, is allows them to review them in one of five designated sites - after signing a confidentiality agreement. This confidentiality agreement prohibits physicians from making a copy and from disclosing the contract content to anyone, including their office partners, spouses, and attorneys.

Despite protests from several Atlanta-area doctors, Promina officials defend their policy as a measure to ensure more favorable terms from managed care companies and to keep information from leaking to competitors.

"It's really in the best interest of the physicians," says Cheryl Iverson, Promina's spokeswoman. And Promina CEO Bonnie Phipps says that during the 18 months her firm has been negotiating contracts for physicians, there was only one incident in which a physician had asked his attorney to review it.

However, William B. Martin, MD, an internist in Lawrenceville, GA, and Spencer Rozin, MD, an internist in Lilburn, GA, consider Promina's new policy an unnecessary burden and a way to discourage physicians from reviewing contracts that may contain contentious and onerous provisions.

Helen Jameson, attorney for the AMA, Randy Gerber, a St. Louis health care attorney, and Steven M. Harris, a health care attorney counseling physicians and health care groups, agree with the Georgia doctors.

Concerned that Promina's new policy will create obstacles that have a chilling affect on physician review, Jameson fears that "Doctors won't be fully apprised of the possible limitations on treatment, patient care, and communication contained in the fine print."

"It's tough enough to get doctors who are very busy to take the time to read agreements at night or after hours, but to ask them to go off their premises to read a contract, it's just not practical," Gerber adds.