Highland Physicians is a 1,500-physician independent physician organization located primarily in Northeast Tennessee and Southwestern Virginia. Highland and Wellmont had a longstanding history and positive relationship until 2010, when senior leadership changed at Wellmont. Highland and Wellmont’s predecessor formed Wellmont Health Network and penned a stockholders agreement in 1993. While the agreement has evolved over the years, prior issues were resolved amicably.
Here are five key notes the recent lawsuit:
1. Highland claims Wellmont “systematically and deliberately undermined HPI, dismantled the network and reduced resources devoted to clinical integration, including making a number of unilateral decisions without HPI’s knowledge,” according to the report.
2. In 2012, Wellmont and Humana Medicare Advantage negotiated just for Wellmont doctors without Highland’s knowledge although the two were “clinically integrated.” Wellmont signed similar contracts with Cigna.
3. Highland claims Wellmont violated their stockholder agreement, breached fiduciary duties and breach of contract.
4. Highland is suing Wellmont for $15 million to $75 million compensatory damages for the health system’s actions over the past six years in addition to $3.9 million for a difference in reimbursement rate under Wellmont employee health benefit plan.
5. The IPA has been trying to work with Wellmont to resolve the issue without legal action, but has been unable to come to an agreement.
6. Wellmont’s media relations director said the lawsuit is “without merit.”
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