The Upper Chesapeake Health System hopes to delay Prudential Health Care Plan's transfer of 14,000 Harford and Cecil county patients to different physicians.
Upper Chesapeake operates Fallston General and Harford Memorial hospitals.
Leonard E. Cantrell Jr., chief executive officer of Upper Chesapeake, said he complained in a letter to the Maryland Insurance Division Thursday, objecting to Baltimore-based Prudential Health Care Plan's instructions that subscribers transfer to new doctors by Sept. 1.
Upper Chesapeake has provided exclusive care for patients of the Prudential Health Care Plan, formerly the Johns Hopkins Health Plan, since 1986, said Cantrell.
Lorraine Tunis, director of public affairs for Prudential Health Care Plan, said the decision to transfer subscribers to other doctors came after contract negotiations broke off with Upper Chesapeake.
She said she could not comment on Upper Chesapeake's complaint because she had not seen it or a letter Cantrell sent to Barbara Hill, president of Prudential Health Care Plan.
When contract renewal negotiations broke off July 30, Prudential Health Care Plan, a subsidiary of the Prudential, one of the nation's largest insurance companies, notified its subscribers in a letter mailed the same day that they must change doctors.
Tunis said negotiations broke off because Upper Chesapeake refused to compromise on certain contract language.
Prudential agreed to negotiate for another 30 days, but also compiled a network of primary-care physicians.
When no agreement was reached by July 30, members were notified of new primary-care arrangements.
Cantrell said the contract dispute centeredon whether or not Upper Chesapeake would continue to provide health care only to Prudential Health Care Plan subscribers. He declined to comment on how much the contract was worth.
"We didn't want to remain exclusive after the Johns Hopkins Health Plan was bought by a for-profit insurance company," said Cantrell. "That was the point of contention."
Cantrell said the gist of his complaint to the insurancedivision is that the patient transfers would be abrupt and would interrupt care for pregnant women or other patients who are receiving care and treatment in which continuity is a key factor.
"We won't be yanking those people out of courses of treat
ment," said Tunis. "If a patient's in a course of treatment, like a pregnancy, we'll work with them to transfer over a period of time."
Tunis said Prudential Health Care Plan's subscribers will benefit from 18 medical offices and 44 doctors. Upper Chesapeake provided five offices and 11 physicians.
"We had a dedicated group," said Cantrell. "These patients will now be added to existing medical practices and we think that's not going to be to their advantage."
Cantrell said Upper Chesapeake is working on arrangements with other health maintenance organizations, which he would not name, to provide health services at its five existing offices.