Posted 4/2/2010 04:56 pm
Updated 1 year ago
The Surgical Hospital said in its lawsuit that Julie Benafield Bowman failed to disclose that attorneys representing United HealthCare of Arkansas bought meals for her before and after she ruled in United's favor in a dispute with the state's three surgical hospitals.
Bowman left the Insurance Department at the end of 2008 and in January 2009 started working as United HealthCare's director of regulatory affairs of Arkansas and Tennessee.
"The many lunches and dinners which [United HealthCare's attorney Nicholas] Thompson and United purchased for Bowman, and the employment of Bowman with Untied, were a benefit or consideration for Bowman rendering a decision favorable to United," the lawsuit alleges. "That conduct would constitute a felony for all involved."
In the fall of 2008, Bowman had interpreted the state's "any willing provider" legislation in a manner favorable to insurers and costly to the state's three surgical hospitals, the Arkansas Surgical Hospital, the Surgical Hospital of Jonesboro and HealthPark Hospital in Hot Springs. The surgical hospitals complained they were being paid less by insurance companies for the same procedures performed at full-service hospitals.
The surgical hospitals argued that AWP should have required some uniform methodology for setting the reimbursement price for various procedures.
In the lawsuit filed Friday, the Arkansas Surgical Hospital sued Bowman and United HealthCare for fraud for failing to disclose the alleged conduct. Thompson and his law firm, Mitchell Williams Selig Gates & Woodyard of Little Rock, were also named as defendants.
The surgical hospital is seeking an unspecified amount of damages for the attorneys' fees and money lost as a result of the 2008 ruling.
Neither Bowman nor Thompson could be reached for comment Friday afternoon. But they both denied any wrongdoing in a March 2009 article in Arkansas Business.
The meetings and meals "had absolutely nothing to do with [the surgical hospitals'] complaint and nothing to do with the ‘any willing provider' issue," Thompson said at that time.
Harry Hamlin, managing director for Mitchell Williams, said Friday that he hadn't seen the complaint.
"For whatever reason, and we think it's ridiculous, they've taken the exact same facts that were already in front of the Circuit Court and are trying to apply them to some new legal theory and put pressure on the folks in the group," he said. "We're not happy that they aren't following through with the administrative process. ... It's irritating more than anything."
The Arkansas Surgical Hospital appealed Bowman's 2008 ruling to Pulaski County Circuit Court and cited an appearance of impropriety as a reason to throw out Bowman's decision.
Pulaski County Circuit Court Judge Jay Moody found in January that there was an appearance of impropriety and sent the case back to the Insurance Department to be retried, where the case is pending.