June 12, 2013
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AMA lauds Supreme Court decision supporting physician rights to collective fee arbitration

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The American Medical Association is hailing this week’s unanimous Supreme Court ruling allowing physicians to collectively arbitrate payment disputes with a health insurance company.

“This important ruling allows thousands of physicians to use class arbitration against a health insurer that has underpaid them for more than a decade,” AMA President Jeremy A. Lazarus, MD, said.

Jeremy Lazarus, MD 

Jeremy A. Lazarus

The dispute began in September 2003 with allegations by New Jersey pediatrician John Sutter, MD, that Oxford Health Plans had regularly “down-coded” and delayed payments to 20,000 network physicians. “A timely class-arbitration would have allowed them to have their payment disputes resolved more expeditiously and cost-effectively,” Melina Martinson, general counsel, Medical Society of New Jersey (MSNJ), said.

The AMA also was critical of nearly a decade of litigation that preceded this week’s Sutter v. Oxford Health Plans decision.

“It is a sad commentary that it took a decade for Dr. Sutter and other New Jersey physicians to exercise the dispute mechanism allowed by their contracts,” Martinson said.

A friend-of-the-court brief urging the court to allow physicians to battle insurer disputes as a group was filed by the Litigation Center of the AMA and State Medical Societies and the MSNJ.