HMSA denies it refused to meet

By James Gonser
Advertiser Staff Writer

The Hawai'i Medical Association's filing of two lawsuits yesterday against the largest medical insurer in the Islands, accusing it of unfair and anti-competitive reimbursement practices, was unavoidable because the insurer had refused to meet with the doctors for the past two years to discuss the issues, said the group's president.

"We were driven to file the lawsuit," said Dr. Gerald McKenna. "It was not something we wanted to take on."

Cliff Cisco, a senior vice president with the Hawaii Medical Service Association, said yesterday that he had not yet seen the lawsuits, but that the procedures HMSA uses to review and pay claims are appropriate and that the insurer has always been available meet to physician groups.

"We meet with physicians all around the state," said Cisco. "We have not met with the leadership of the HMA in quite a while because they've not wanted to talk with us.

"This idea that we don't speak to physicians collectively is not correct. We have tried (to talk to them) and they have refused our offers."

HMA's complaint, which asks the court to halt the reimbursement practices, says the system has cost local physicians millions of dollars and threatens continuity of patient care. It also says that because HMSA is the largest health plan in the Islands, insuring two-thirds of the population, physicians have been forced to accept HMSA practices at the risk of losing patients.

"We want HMSA to eliminate the unfair practices that they have instituted against physicians over the past 12 years," McKenna said.

Cisco said similar lawsuits across the country have not gone anywhere and this one will likely be an expensive waste of money.

"This is going to cost the community something and we hope we can minimize that," Cisco said yesterday.