Massachusetts Medical Society sues group insurance commission over physician rankings

The Massachusetts Medical Society on Wednesday filed a lawsuit against the state's Group Insurance Commission, which purchases health insurance for most state employees and retirees, over its physician ranking system, the AP/Boston Herald reports (AP/Boston Herald, 5/21).

The lawsuit seeks to end the ranking system or require the commission to use transparent ranking standards, the Herald reports. The ranking system has three tiers to categorize doctors based on cost and quality measures, and insurers charge patients more to see physicians in the lower tiers (McConville, Boston Herald, 5/22). The suit alleges that some physicians in the lower tiers have been defamed and that patients who contribute higher copayments to see those doctors have been defrauded, the Boston Globe reports.

Massachusetts Medical Society President Bruce Auerbach said that efforts to improve the physician ranking program have failed. Auerbach said that the most "glaring problem" with the clinical performance improvement initiative is that it uses "inaccurate, unreliable and invalid tools and data." Dolores Mitchell, executive director for GIC, said, "We agreed to a lot of the suggestions" the medical society made, "but not all of them" (Krasner, Boston Globe, 5/22).

The lawsuit also names Tufts Health Care and UniCare Life and Insurance (Boston Herald, 5/22).