IPA sues Wellmont Health for allegedly trying to drive it out of business: 6 things to know

Highland Physicians, a Kingsport, Tenn.-based independent practice association, has sued local Wellmont Health System, claiming the health system has spent six years working to destroy the association, according to the Kingsport Times-News.

The lawsuit alleges Wellmont Health has attempted to put the IPA out of business by cutting of its resources and secretly signing contracts with payers, according to the report.

Here are six things to know about the lawsuit.

1. The 1,500-physician IPA filed the lawsuit on Feb. 2 in Sullivan County Law Court to recover money it believes it is owed. It seeks compensatory damages of $15 million to $75 million and an additional $3.9 million for reimbursement rate differences under Wellmont's employee health benefit plan, according to the report.

2. The issues began in August 2010 when Wellmont Health leadership, led by then-CEO Denny DeNarvaez, "took an adversary position to doctors not employed by Wellmont," the lawsuit states, according to the report. Prior to this, since 1993, Highland Physicians and Wellmont worked successfully together under a hospital-physician organization called Highlands Wellmont Health Network, according to the report.

3. In the lawsuit, Highland Physicians claims Mr. DeNarvaez and Alice Pope, then-executive director of HWHN, together tried to dismantle the network and cut off resources for clinical integration, according to the report.

4. Specifically, Highland Physicians claims Wellmont signed a contract with Humana Medicare Advantage in June 2012 without the IPA's knowledge, which violated the hospital-physician organization's stockholder agreement. It claims similar actions were taken with Cigna, according to the report.

5. Highland Physicians said in a statement that it attempted to resolve these issues in the past without legal action, stating that it now "is determined to proceed in a manner that yields a fair outcome and would best allow the parties to continue to work together for the health of the community," according to the report.

6. Wellmont media relations director Jim Wozniak told the Times-News in a statement the system believes the IPA's claims are unsubstantiated and it plans to defend itself "vigorously."


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