By Scott Sleek
Monitor staff

New Jersey psychologists have taken a step that will accelerate an lawsuit they have filed against a managed-care company for impeding their ability to deliver quality care.

The plaintiffs?seven practitioners and the New Jersey Psychological Association (NJPA)?requested that the defendants sign a consent order to drop three counts that a federal judge had ordered to arbitration. MCC agreed, allowing the remaining counts to proceed immediately to litigation.

The seven psychologists are suing MCC Behavioral Care Inc. in response to the company?s decision to drop them, along with more than 20 other psychologists, from its provider panel. They said they were dismissed after they asked for more sessions with some patients than the company wanted to cover.

The three counts dealt with contractual issues related to MCC?s decision to dismiss the psychologists? from the network. Judge John Bissell, of the U.S. District Court in Newark, N.J., had ordered the litigation be delayed pending the arbitration proceedings. But the plaintiffs dropped those counts so that the larger, public policy issues raised in the suit could get a faster hearing. The plaintiffs view the lawsuit as a test case?a chance to spotlight the type of managed-care practices that sacrifice quality care.

?The psychology community, believes the important purpose to be served in this case is to put the practices of MCC under sufficient legal scrutiny,? said Russ Newman, PhD, JD, APA?s executive director for practice. ?We believe this suit will expose the way managed-care arrangements can be used to obstruct access to necessary care, simply to save money and maximize profits.?

Bissell in September agreed to hear the plaintiffs? key allegations, rejecting MCC?s request to dismiss the suit. The complaint focuses primarily on the providers? ability to advocate for their patients? well-being, and to make clinical decisions in the patients? best interest. The psychologists say the company interfered with their professional judgment and unjustly severed their important ongoing therapeutic relationships with their patients.

In his decision to hear the case, Bissell said that:

? New Jersey law protects health professionals? right to advocate for their patients in utilization reviews.

? Managed-care companies are public services much like hospitals. (New Jersey courts have repeatedly ruled that physicians cannot be removed from hospital staffs without a fair hearing).

? The plaintiffs may be protected by a New Jersey Supreme Court ruling that allows people to sue if they are fired for such legally protected conduct as pointing out safety hazards or other problems in the workplace.

The suit is beginning to attract media attention. In addition to extensive press coverage, the lawsuit was the focus of a Dec. 9 installment of the Court TV program ?Miller?s Law.? Host Arthur Miller moderated a panel of discussants that included APA?s Newman; William Maderer, who represents the New Jersey psychologists in the MCC suit; Katherine Benesch, a specialist in health-care litigation; and Daniel Callahan, a medical ethicist.

Newman argued on the show that the case highlights the managed-care industry?s efforts to make practitioners solely responsible for patient care, while restricting their ability to fulfill that responsibility. Benesch said managed-care companies should be held responsible only for financial decisions in health plans, not for the actual care that is delivered. But Newman countered that managed-care companies?because of the tight control over clinical decision-making?are in the business of providing care, not just paying for it. Therefore, he said, those companies should be held accountable for treatment outcomes.