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Judge orders HMO to accept psychiatrist back in the fold

| Friday, March 14, 2003

A health-maintenance organization has been ordered to reinstate an Oakland psychiatrist dropped from the health group's provider rolls in 2001 after the doctor declined to hand over patient records.

Allegheny County Common Pleas Judge Joseph James ruled this week that Green Spring Health Services and Magellan Behavioral Health improperly ended patient treatment agreements with Dr. Daniel Shrager after he raised ethical concerns about releasing medical records without patient consent.

James ordered Magellan and Green Spring, health providers under the Highmark Blue Cross Blue Shield system, to reinstate Shrager as a full member and to allow him to accept new patients covered by the health groups. Highmark was also a defendant in the case.

Under the ruling, Shrager will be required to provide Magellan with redacted medical records from patients who approve their release.

Ray Middleman, attorney for Shrager, said his client went to court because he saw a threat to medical ethics. The decision, he said, shows the court agreed. "The court took an affirmative step to try to protect patients' rights," Middleman said.

But Kristin Brunnworth, a spokeswoman for Magellan, said while the ruling requires Shrager's reinstatement, it also requires him to release records. "The judge is requiring him to do what we've asked of him all along," Brunnworth said.

Records are released by Magellan's doctors only after patient authorization, she said. She said her company ensures patient records are seen only by qualified people who need to see them to ensure adequate care.

"We need to make sure the patient is getting quality treatment and to do that we need to see those records," Brunnworth said.

No ruling has been made on possible monetary damages in the case.

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