Lawsuit Questions Bowman's Ties in United HealthCare Case

by Mark Friedman  on Monday, Mar. 23, 2009 12:00 am  

Still, "the additional documentation that we've received makes this look very, very troubling," Perroni told Arkansas Business last week.

Bowman said nothing improper was discussed during the meals, and she said she had also attended a dinner paid for by Arkansas Surgical Hospital.

On Aug. 20, 2007, Bowman and three others from her staff attended an "AWP dinner" at the surgical hospital, according to Bowman's calendar, which the Arkansas Insurance Department released to Arkansas Business under the Freedom of Information Act. The calendar entry said Lynn Weeks, the surgical hospital's CEO at the time, and 18 others attended the dinner.

Perroni couldn't be reached for comment on that event. 

Little Rock attorney Chuck Banks, who is representing Bowman, said in a statement to Arkansas Business last week that she did an "exemplary job" as insurance commissioner.

Bowman "conducted a full and complete hearing, permitting the parties to make a complete record by the presentation of evidence, testimony, documents, and objections," Banks said in the statement. "She fulfilled her oath and performed her duties in a legal, ethical, and diligent manner without arbitrary, capricious, or abuse of discretion utilized in the procedures or the final order."

Banks said that he believed her order will be upheld. A spokesman for United HealthCare said the insurance company is still gathering facts about the case, but stands behind Bowman.

"United HealthCare remains firmly of the belief that Commissioner Bowman's decision was fair, unbiased and correct on the merits," said spokesman Roger Rollman in a prepared statement. "And [United HealthCare] fully expects her decision to be upheld by Arkansas courts."

The Case
In January 2007, the Arkansas Surgical Hospital filed a complaint with the Arkansas Insurance Department seeking clarity on the Patient Protection Act that went into effect in 2005.

The Arkansas Surgical Hospital complained it was being paid less by insurance companies than full-service hospitals in Little Rock performing the same procedures. That disparity is believed to have cost the surgical hospital millions of dollars.

The Patient Protection Act, commonly known as "any willing provider," opened the preferred provider networks in Arkansas to medical providers that had previously been excluded even though they were willing to accept the same reimbursement rates as in-network providers.

Arkansas Surgical Hospital had argued to Bowman that, under the law, insurance companies should have some uniform methodology for setting the reimbursement price for a procedure.

 

 

Please read our comments policy before commenting.