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SOUTH JERSEY DOCTORS' GROUP FILES TO STOP HEALTH PLAN CHANGES; SEEKS TO RESTRAIN THE PRUDENTIAL AND PRUCARE FROM CHANGING EXISTING SYSTEMS

SOUTH JERSEY DOCTORS' GROUP FILES TO STOP HEALTH PLAN CHANGES; SEEKS TO RESTRAIN THE PRUDENTIAL AND PRUCARE FROM CHANGING EXISTING SYSTEMS
 ATLANTIC CITY, N.J., Jan. 22 /PRNewswire/ -- A group of New Jersey physicians have sued a major national insurance carrier and its health care organization to delay them from dismantling existing health plans and possibly forcing as many as 40,000 southern New Jersey residents into finding new family doctors.
 Southshore Health Services, Inc. has filed a civil action in the Superior Court of New Jersey and an arbitration to stay The Prudential Insurance Company of America and Prudential Health Care Plan, Inc. from terminating the Managed Medical Provider and Health Maintenance Organization agreements it has with the group.
 Southshore is an organization of more than 340 primary and specialty care physicians serving New Jersey's Atlantic, Cape May, Ocean and Cumberland counties. The group, whose predecessors date back to 1971, is the exclusive provider of health care services to participants in an HMO it formed in 1977 and which was acquired by PruCare in 1985. It also provides exclusive health care delivery for a number of other PruCare-administered programs added since 1985 such as Bell Atlantic, Marriott and the state of New Jersey.
 Stephen Gosin, M.D., president of Southshore, said that the action was taken to prevent PruCare and The Prudential from taking steps to implement an alternate health care delivery system that would be outside the contractual agreement with Southshore. The alternate plan would replace Southshore doctors and force plan participants to find new physicians. Gosin said that his group wants to restrain PruCare action until an arbitration can be held that would provide court protection for the Southshore physicians under its agreements made with The Prudential and PruCare in 1985 and 1986.
 According to Gosin, Southshore has attempted unsuccessfully to resolve the issues of an alternate health care delivery system with The Prudential and PruCare. He said that the physician/patient relationship between a minimum of 40,000 individuals and more than 340 physicians will be disrupted with a new mix determined solely by The Prudential and PruCare without any opportunity for physicians, patients or employers to have a say.
 "Many people have had a doctor/patient relationship for years," Gosin said. "We would like to minimize the need for them to change that relationship."
 Gosin said that the group is concerned about the quality of and access to medical care to be provided under Prudential's alternate delivery system.
 "The Southshore organization insures the quality of care provided patients under the existing delivery system," Gosin said. "We do this through a monitoring system that reviews doctors, hospitals and use procedures on a regular basis. This control is now done by highly qualified, impartial medical professionals who are patient advocates. We would not like to see this cast aside."
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 /CONTACT: Stephen Gosin, president of the Southshore Health Services, 609-653-0422, or Steven Sacharow, attorney, 609-234-4668, for the Southshore Health Services/ CO: Southshore Health Services, Inc. ST: New Jersey IN: HEA SU:


MP-MK -- PH018 -- 2237 01/22/92 11:22 EST
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Publication:PR Newswire
Date:Jan 22, 1992
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