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Physician reinstated in PPO after three-year legal battle

Physician Practice Advisor, December 6, 2006

An arbiter has ordered a preferred provider organization (PPO) in New Jersey to reinstate a physician it had terminated and rescind its notifications of the termination to the National Practitioner Databank and to the New Jersey State Board of Medical Examiners.

The physician, an otolaryngologist, had been a member of the PPO for seven years. The organization accused him of performing endoscopic procedures without medical necessity and of keeping insufficient records for four patients and terminated him.

However, after three years of appeals and arbitration, the PPO was ordered to reinstate him, which is extremely rare, according to a press release by Wolf, Block, Schorr and Solis-Cohen LLP, the firm that represented the physician.

To read the press release, click here.

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