Published Feb. 2, 2004

The Parker Hughes Cancer Center is dropping out of Minnesota's two largest health care plans in the face of their investigations of its patient care, insurance officials said Monday.

The Roseville clinic, which is also under investigation by the Minnesota Board of Medical Practice, cut its ties with Medica last week, days after learning of the insurer's "serious concerns" about patient care and business practices at the clinic, according to a Medica official.

Blue Cross and Blue Shield of Minnesota, which is conducting a separate review of the clinic's patient care, is discussing "how to end our relationship in the most compassionate way for patients," said Dr. Bill Gold, the insurer's chief medical officer.

It is unclear what effect the terminations, if finalized, will have on the clinic's finances, but together both insurance companies paid for the care of 750 clinic patients over the past year, according to the health plans.

Health plan officials said they would make provisions for current clinic patients so that their care would not be interrupted. Some members will also be able to use out-of-network benefits if they choose to continue care at the clinic. Such benefits typically carry a higher copayment.

Medica wouldn't reveal the details of the concerns it had with the clinic, but Dr. Charles Fazio, Medica's medical director, said they involved more than the cost of care there.

"This is more extensive and serious than any investigation that we've done in recent memory," Fazio said.

He said Medica began an investigation last year that included an extensive review by independent experts of the care provided by the clinic to 16 Medica members. He said results from eight of the cases were forwarded to state and federal authorities, including the FBI and the state Medical Board, which licenses and disciplines doctors.

Dr. Fatih Uckun, the clinic's founder, gave a different reason for the difficulties with insurers. He said Blue Cross and Medica wanted to put limitations on how patients should be treated. The clinic treats patients with cancer or with inflammatory disorders such as arthritis.

"Parker Hughes and certain insurance companies do have differences regarding what is, or what constitutes, standard of care," he said.

Fazio described Uckun's action as a preemptive move to avoid the possibility of being dropped from the Medica network.

In December, a Star Tribune report disclosed that the clinic wooed desperate patients with inflated promises about their chances of recovery and repeatedly charged insurers for treatments that experts say were unnecessary. The state Medical Board has been investigating billing practices and excessive treatment of terminally-ill patients, and the FBI has made inquiries about allegations that Uckun has solicited financial contributions for the clinic from medical groups in exchange for clinic business.

Blue Cross, which had been reviewing the care of 100 patients, said that it has approached the clinic about its treatment standards but that those talks have broken down. Gold said: "It is unlikely we are able to find common ground."

Uckun declined to characterize discussions with Blue Cross. He defended the clinic's treatment standards.

"Our primary and overriding concern was that patients receive excellent quality of care and treatment," he said. "We don't give up on patients where there is a real chance."

He stressed that the clinic will work financially with any Medica patients if they choose to continue receiving care there.

He said that he had no knowledge regarding Medica's concerns over the clinic's business practices.