FOR IMMEDIATE RELEASE
December 2, 1999

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(Washington, DC) - Florida psychologist Richard Brown, Ph.D. charged this week that Magellan, the largest behavioral health managed care company in the country, arbitrarily terminated mental health services to his patients in retaliation for Dr. Brown's efforts to enforce his agreement with Magellan.

In an amended complaint filed in the Hillsborough County Circuit Court in Tampa against Magellan CBHS Holdings, Inc. and Merit Behavioral Care of Florida, Inc., Dr. Brown alleges that, through arbitrary blanket terminations of care, the managed care company inappropriately interfered with the relationships that Dr. Brown had developed with his patients. The lawsuit charges that Magellan ignored repeated warnings from Dr. Brown that termination of care would be detrimental to his patients? well being, especially those who were in a critical phase of treatment.

The lawsuit further charges Magellan with fraudulent misrepresentation and breach of contract for failing to permit Dr. Brown to exercise his professional judgement in providing services to his patients and for its refusing to pay for authorized services rendered to Dr. Brown?s patients. The amended complaint expands on the initial lawsuit filed by Dr. Brown in April 1999 charging Magellan with failure to reimburse for preapproved mental health services.

The American Psychological Association (APA) and the Florida Psychological Association (FPA) are supporting the lawsuit against Magellan.

"The issue here is managed care decision making without regard to patient well-being. We?re concerned about managed care companies making profit-driven decisions that ultimately harm patients by preventing them from receiving necessary mental health care," says Russ Newman, Ph.D., J.D., APA?s executive director for professional practice.

"I regret having to take this to the court level," says Dr. Brown, "but I feel it?s the only way to ensure continuity of patient care. The managed care company?s tactics created a critical situation. Now we need to make certain that my patients are going to get the care they need and deserve."

The Brown vs. Magellan lawsuit is one a series of four lawsuits brought with the support of APA to challenge managed care practices that endanger the health of patients and prevent managed care companies from usurping the clinical decision making of qualified health care professionals. APA?s national legal strategy is designed to expose, through a series of lawsuits, the degree to which managed care companies actually control and influence treatment decisions and to force greater accountability around quality health care, not just costs.

Other cases currently pending:

• U.S. District Court for the District of New Jersey - lawsuit against MCC Behavioral Health Care, brought by the New Jersey Psychological Association (NJPA) and seven psychologists. NJPA and the psychologists filed the complaint as a result of MCC terminating the psychologists from its provider network "without cause," alleging the termination to be a means of MCC controlling treatment decisions by threat of removal for providers who do not comply with the company's treatment decisions.
• Superior Court of the State of California for the County of Los Angeles - lawsuit against Aetna U.S. Healthcare, Inc. of California; Human Affairs International, a former subsidiary of Aetna; and Adventist Health Care, a subcontractor for Human Affairs International filed by the California Psychological Association. The complaint charges that Aetna?s managed care entity engaged in false advertising. The complaint alleges that California residents were misled by claims of prompt, accessible mental health treatment services that the managed care entity does not, in fact, provide.
• Superior Court of the District of Columbia - lawsuit against Blue Cross/Blue Shield of the National Capital Area (BCBSNCA) and its HMO subsidiary, CapitalCare, brought by the Virginia Academy of Clinical Psychologists along with six clinical psychologists and two Blue Cross patients. The complaint states that BSBSNCA engaged in false advertising by promising employers who purchase the BCBSNCA/CapitalCare plan and patients who use the plan certain benefits that are not delivered.