After receiving a number of physician complaints, CMA last year analyzed the PacifiCare/United Healthcare physician contract and found that it in many ways is inconsistent with state laws and regulations, including the Knox-Keene Act.

Although PC/UHC has since made a number of changes to the contract, CMA continues to have concerns with some of its provisions.

A detailed analysis of the contract, and its flaws, is available to members at the members-only website. There you will also find objective written analyses of a dozen other major health plan contracts.

CMA reminds physicians that before signing a health plan contract, it is important to know what value that relationship will bring to your practice. Physicians do not have to accept bad contracts or contracts that are not mutually beneficial.

To help physicians negotiate and manage complex third-party payor agreements, CMA has published a contracting toolkit, “Taking Charge: Steps to Evaluating Relationships and Preparing for Negotiations—A Focus on Payor Contracting.” The toolkit is available free to members at the members-only website Nonmembers can purchase the toolkit for $100 in the CMA bookstore.

Contact: Aileen E. Wetzel, 916/444-5532 or awetzel@cmanet.org.