Profits over Patients: The Nightmare Scenario for Managed Care Patients
San Luis Obispo, CA – The medical director of Coastal Communities Physician Network (CCPN) and Bakersfield Family Medical Center (BFMC), and Heritage Provider Network (HPN) filed a wrongful termination lawsuit alleging retaliation for his refusal to participate in an unlawful scheme to deny adequate medical care to patients.
According to the lawsuit, nursing staff and non-medical administrators routinely denied medical services, even when approved by the treating physician and their own medical director. The companies’ managers mandated a 6% rate of denials of all out-patient referrals, without consideration of the patients’ needs. They also refused to permit more than 3 elective procedures per day, regardless of the urgency of those procedures.
The terminated medical director, John S. McGee M.D., explained that he strongly supports managed care, but what these companies are doing is nothing more than managed profits. He was fired because he advocated for quality healthcare for his patients and insisted on performing his duties under the law.
These managed care administrators placed profits over patients. They are responsible for the care of hundreds of thousands of patients throughout southern and central California.
You can view the entire complaint here. Complaint (pdf download).
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