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Friday, April 9, 2010 - 4:26am

Doctors Get Ruling For Access To Join HMO's

An organization representing thousands of doctors in Georgia says a ruling against the state’s largest healthcare insurer is a ‘win’ for physicians and patients.

At issue is interpretation of Georgia’s “Any Willing Provider” law. It allows licensed doctors and providers in good standing to become a participating provider.

State Insurance Commissioner John Oxendine says that should apply also to PPO and HMO networks. He says doctors with an Athens-based physicians group should be given access to join networks with Blue Cross/Blue Shield.

Donald J. Palmisano, Jr. with the Medical Association of Georgia says doctors can better serve their patients. And for the patients:

“This gives them the ability to choose a physician but more importantly their own physician based on the policy they purchase, but also to continue the care they’re receiving.”

In a statement, Blue Cross/Blue Shield says this ruling “defeats the purpose of having varying levels of coverage available to members.” The insurer is considering an appeal.