Illinois AG charges docs colluded to black-ball Medicaid patients

Legal News Line Jun. 19, 2007, 5:11am

Lisa Madigan

SPRINGFIELD -- Illinois Attorney General Lisa Madigan has charged the biggest two medical clinic chains in the college twin-towns with breaching anti-trust laws. Madigan announced late last week that the two broke the law by agreeing not to accept new Medicaid-eligible patients seeking primary care. The aim, she added, was to increase reimbursement rates and accelerate payments from the state. She said the defendants, Carle Clinic Association of Urbana and Christie Clinic of Champaign, employ 90 percent of the physicians in Champaign County. Their alleged actions left Medicaid-eligible residents "with fewer choices to obtain quality primary medical care." The attorney general also claims the policy forced potential Medicaid patients to seek primary health care at hospital emergency rooms. ER visits are more expensive to the state than treatment by a physician, she added. Madigan filed suit late last week in the sixth circuit court of Champaign County seeking an order that the clinics begin accepting new Medicaid-eligible patients. It also seeks a maximum fine of $1 million and damages incurred by state agencies and patients. The suit alleges that in March 2003, Carle Clinic Association (CCA) and Christie Clinic "agreed to boycott new Medicaid patients knowing that their boycott would leave many Medicaid-eligible patients ... without access to medical care." Champaign County is home to some 20,000 Medicaid-eligible patients, Madigan claims. Its twin towns of Champaign-Urbana are also home to the University of Illinois, one of the country's largest state college campuses. Representatives of both clinics denied collaborating illegally with competitors over their Medicaid-patient policies. And Care Clinic Association President and CEO Dr. Bruce Wellman told the AP he blames the state's health-care bureaucracy for his company's Medicaid decisions. Madigan's suit "highlight[s] the need to fix the reimbursement model in the health care delivery system in this state so providers and patients are given the resources they need," Wellman said.

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