Reno Diagnostic Centers filed a civil lawsuit against Washoe Medical Center seeking $30 million in punitive damages after Anthem Blue Cross and Blue Shield terminated its contract for imaging services. Reno Diagnostic says the hospital created a financial arrangement, or "package deal" that pressured Anthem into awarding the hospital exclusivity rather than lose access to services available only at Washoe Med.
Reno Diagnostic Centers, founded in 1985 has two Reno locations. It was the first to install an array of medical diagnostic imaging services, says Ross Golding, MD, medical director. Those firsts included an MRI scanner, preceeding all the local hospitals by several years, he says, and it was the exclusive provider of digital mammography. For four years, the only provider of PET scans.
"We have not encountered this before at Anthem," says Golding. "We were told by a representative at Anthem that Washoe Med demanded an exclusive agreement."
"We're seeing an elimination of consumer choice," he says. "This change eliminates the choices for our referring physicians and their patients."
"We expressed our concern in various letters to Washoe Medical Center and they were dismissed," says Golding. "So we felt the need to file a lawsuit."
Reno Diagnostic Centers is represented by Kent Robison at Robison, Belaustegui, Sharp and Low of Reno. The suit was filed in the Second Judicial District Court of Nevada.
"This strong-arm bullying behavior by Washoe Medical Center is meant to bully physicians and Saint Mary's Hospital," says Golding. "They are using strong-arm methods to leverage agreements with doctors and insurance companies to achieve dominance. Eventually they could become a monopoly."
"Anthem," says Sally Vogler, director of public relations at Anthem Blue Cross Blue Shield, "has a responsibility to manage the cost of health care for our members. One way is to negotiate some degree of exclusivity in exchange for price considerations."
Don Butterfield, director of communications at Washoe Medical Center, says, "It is common in this community and the health care industry in general for an insurer to develop a network that doesn't include every provider.
"We are a private and not-for-profit organization," he says, adding that Washoe Medical Center is the sole providor of programs such as the Level II Trauma Center, Pediatric Intensive Care Unit, Neuro biplane angiography, JCAHO Accredited Stroke Program, Novalis Shaped Beam Radiosurgery, and Lung Cancer Screening program.
"We do not prohibit any person, insurance company or organization from accessing services including those not available through other providers," says Butterfield.
"We routinely care for patients from throughout the region, including those who belong to competing provider and insurance networks," he says, and adds:
"We will vigorously defend these claims in court."
