The Johns Hopkins University has sued two physician groups and the financially troubled parent of the CareFirst health maintenance organization for nearly $500,000 that the university's doctors claim they are owed.
The lawsuit alleges that the two physician groups, Maryland Health Physicians Associates and Berdann & Krieger, sent CareFirst members to Hopkins doctors but have failed to pay for LTC medical services.
In turn, the suit claims, HealthCare Corporation of America, which owns CareFirst, is liable for any amount that remains unpaid by the doctors' groups.
"We've been talking to them about this and a resolution for this for a long time in an amiable sort of way," said Frederick G. Savage, associate general counsel for the university. "When it became apparent that we couldn't solve it, we thought it was an appropriate thing to do to protect us."
Mr. Savage said the lawsuit was partially prompted by the recent action taken by Maryland insurance regulators, who froze the assets of CareFirst and an affiliated HMO two weeks ago after finding the two health maintenance organizations nearly $12 million below regulatory net-worth requirements.
Although Mr. Savage said that he did not know how old the unpaid claims were, he said Hopkins stopped treating patients of Berdann & Krieger about 18 months ago.
The HMO's financial difficulties, however, do not appear to have led to the late payments.
The lawsuit states that HealthCare Corporation of America contracted with the two physician groups to provide medical services to its HMO members. Under the contracts between the two physician groups and the HMO, the physicians were paid a monthly fee for each HMO member they agreed to see. Referrals to Hopkins specialists were to be paid by the physician groups.
Maryland Health owes Johns Hopkins $474,361.77, according to the lawsuit, filed Monday in Baltimore Circuit Court. The suit charged that Berdann & Krieger owes $23,270 to the university, which employs the Hopkins doctors.
Maryland Health's president, Dr. Burton D'Lugoff, who is also a director of CareFirst's parent, could not be reached for comment yesterday. Representatives for Berdann & Krieger did not return phone calls. HealthCare said in a statement that its lawyers were reviewing the case.