ARBITRATION AWARD EXONERATES CENTRAL ILLINOIS

A lengthy arbitration with millions of dollars at stake has been resolved, with a decision that fully exonerates a prominent group of allergy and respiratory physicians charged with breach of contract and fraud in a participating provider agreement with a major Midwest health insurer. The award included recovery of wrongfully withheld "withholds" and attorneys' fees the physicians incurred in the four-year battle.

After four consecutive renewals of what was originally a one-year agreement, Health Alliance Medical Plans, Inc. filed a complaint that charged a group of prominent central Illinois physicians retained as contract service providers for the company's HMO members with having provided services that were "inappropriate and not medically necessary" and sought to recover an estimated $1.3 million. The physicians, Central Illinois Allergy and Respiratory Services, retained Lowis & Gellen attorneys Jerry P. Clousson and Mark J. Smith who successfully disproved those claims and presented a persuasive counterclaim documenting that Health Alliance Medical Plans had not honored its obligation to return withheld fees to the physicians.

A panel of arbitrators considered the evidence and arguments and found in favor of the physicians on all issues of all counts, with the exception of one minor counterclaim.

The arbitration was brought before the American Health Lawyers Association Alternative Dispute Resolution Service in accordance with Health Alliance's Participating Provider Agreement.

The physicians' counsel, Lowis & Gellen, provides corporate counsel and dispute resolution representation to the health care industry, including hospitals, provider groups and physicians, in arbitration, mediation, trial and appellate courts in several states. More information on the attorneys and practice of Lowis & Gellen can be found at www.lowis-gellen.com


FOR ADDITIONAL INFORMATION CONTACT:
JERRY P. CLOUSSON, Of Counsel
Lowis & Gellen
312-456-2714 312-364-8778
jclousson@lowis-gellen.com
MARK J. SMITH, Partner
Lowis & Gellen
msmith@lowis-gellen.com