Judge Finds Appearance of Impropriety in AWP Case
by January 25, 2010 12:00 am 114 views
Pulaski County Circuit Court Judge Jay Moody found in mid-January an appearance of impropriety in a former Arkansas Insurance Department commissioner’s handling of an appeal involving the state’s “any willing provider” legislation and sent the case back to the Insurance Department to be retried.
Former Arkansas Insurance Commissioner Julie Benafield Bowman ruled in the fall of 2008 in favor of United HealthCare of Arkansas in a dispute with the state’s three surgical hospitals.
Bowman had interpreted the state’s “any willing provider” legislation in a manner favorable to insurers and costly to the state’s three surgical hospitals, the Arkansas Surgical Hospital in North Little Rock, the Surgical Hospital of Jonesboro and HealthPark Hospital in Hot Springs. The surgical hospitals complained they were being paid less by insurance companies for the same procedures performed at full-service hospitals.
The surgical hospitals said they believe that under AWP there should have been some uniform methodology for setting the reimbursement price for a procedure.
Sam Perroni, an investor in Arkansas Surgical Hospital and one of its attorneys, appealed Bowman’s ruling to Pulaski County Circuit Court.
He said Bowman shouldn’t have ruled on the case after leaving the Insurance Department, she took a position with United HealthCare.
Perroni also said in court filings that attorneys for United HealthCare bought meals for Bowman, before and after she ruled in its favor.
In a letter to attorneys dated Jan. 11, Moody sent the case back to the Arkansas Insurance Department to be retried. The current commissioner for the Insurance Department is Jay Bradford.
“We’re just fine with that,” Perroni said Monday. “Now we’ll have one that’s fair.”
Neither Bowman nor her attorney, Chuck Banks of Little Rock, could be reached for comment.
In March, Bowman denied the allegation of impropriety.
The surgical hospitals don’t “have the law or the facts on their side and they’re grasping at straws.”
She said that the surgical hospitals were attacking her credibility and integrity because “they don’t have anything else.”