Lawsuit Questions Bowman's Ties in United HealthCare Case

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

"We never said we should be paid the exact same amount," Perroni told Arkansas Business in May 2008. "We just said under the law, they are required to pay us the exact same way."

The Arkansas Surgical Hospital named United HealthCare, QualChoice and Arkansas Blue Cross & Blue Shield in its complaint.

The insurers countered that health insurance premiums would rise if all hospitals were paid the same.

The surgical hospital wasn't sure exactly how much less it was being paid than the full-service hospitals because it was never allowed to see the contracts.

Bowman found that the contracts contained confidential information and wouldn't release them.

Still, Bowman found in December 2007 that AWP didn't "require identical payment to hospitals for similarly performed services."

The Arkansas Surgical Hospital, joined by the Surgical Hospital of Jonesboro and HealthPark Hospital in Hot Springs, appealed that ruling

In April 2008, Bowman held more hearings. She issued her second ruling in September and found once again in favor of the insurance companies.

The Appeal
On Oct. 15, the three surgical hospitals sued Bowman in Pulaski County Circuit Court to overturn her ruling. Initially, the hospitals didn't question whether Bowman should have recused herself from the case.

But after Bowman announced that she was leaving the Insurance Department and would take a job at United, it set off alarm bells with Perroni.

"These facts suggest that, prior to her entry of the Order, the Commissioner may have faced an irreconcilable conflict of interest requiring her disqualification," Perroni said in one of his motions. "Whether the Commissioner was disqualified must be decided on a showing of an objective appearance of impropriety or a showing of actual bias. The facts known at present strongly suggest that both exist."

He said that Bowman knew her term would expire at the end of 2008 and that she would need another job.



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