HARRIS METHODIST: Settles With Doctors Over Payments
"A months-long court fight between Harris Methodist Health Plan and the Fort Worth Clinic ended [Monday] with a secret settlement," the Fort Worth Star-Telegram reports. The case, in which Fort Worth Clinic primary care physicians charged that the health plan's capitated compensation system encouraged doctors "to deny necessary medical care," was scheduled to go to trial next Tuesday. "Both parties, citing a mutual confidentiality agreement, declined to comment on the terms of the settlement," the Star-Telegram reports.
Squeeze On Prescription Benefits
However, the Star-Telegram reports that Harris Methodist "did disclose that it has boosted the share of its overall budget that is devoted to prescription drugs." The pharmacy budget was at the core of the dispute between the doctors and the health plan because "the large majority of Harris primary-care physicians were over their pharmacy budgets," which put pressure on the doctors to "make up at least part of that liability by being under-budget on other expenses, such as" referrals to specialists. According to Harris spokesperson Brian Levinson, as of January 1, "the pharmacy budget increased to 11.2% of the average premium," up from 9.6% previously. However, Levinson said, "It's not part of the settlement." He said it was a "change ... made 'in light of feedback from physicians.'" George Parker Young, the attorney for the Fort Worth Clinic, said the issue of "whether the Harris incentive system violates" a "new state law that governs HMO contracts with physicians" is still unresolved (Fuquay, 2/11).