Blue Shield claims that some of the 2,300 physicians affiliated with Monarch began declining treatment to Blue Shield members, even though the contract between the physician group and payor is not set to expire until May 1. Blue Shield also claims Monarch aimed to steer Blue Shield customers away from their current insurer and towards competing health plans.
Optum, a unit of UnitedHealth Group, acquired the management of Monarch, an independent physician association, last fall. In its demand letter, Blue Shield also says it was supposed to be asked for consent before a Monarch transaction, and refused to grant consent, but Monarch proceeded with the deal anyway.
Monarch’s CEO, Bart Asner, has said the group is not aware of any instance in which a physician declined treatment of a Blue Shield member. He also said Monarch objects to the “mischaracterizations made by Blue Shield,” according to the report.
The case has been submitted for binding arbitration rather than filed with a court, according to the report, due to terms of the Monarch-Blue Shield contract.
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