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HMO, doctors trying to unionize file arguments with labor board

SHARE HMO, doctors trying to unionize file arguments with labor board

TRENTON, N.J. (AP) -- Health-maintenance organizations have turned independent, Marcus Welby-style physicians into employees controlled by rules and financial incentives, claims a labor union seeking federal permission to organize doctors for collective bargaining.

In a legal brief filed late Thursday with the National Labor Relations Board in Philadelphia, Local 56 of the United Food and Commercial Workers Union argues that AmeriHealth HMO Inc. unilaterally decides what fees the doctors receive and, often, what care they give patients.The union is targeting AmeriHealth, hoping to set a precedent that would allow doctors in any HMO to unionize.

"We believe that these people aren't independent contractors at all, not in the true sense of the word," Anthony Cinaglia, president of the union, said Friday.

The physicians say forming a union would help them regain control over medical decisions, improving quality of care.

AmeriHealth, in its own brief, counters that the doctors are still independent contractors -- and that that was clearly proved during 14 days of hearings before the NLRB last fall, the first ever on the issue.

"AmeriHealth plays absolutely no role in the day-to-day operations of these doctors," Rich Rosenblatt, an attorney for the subsidiary of Philadelphia-based Independence Blue Cross, said Friday.

He said the doctors treat patients enrolled in numerous HMOs and receive at most 12 percent of their income from AmeriHealth.

The NLRB regional director in Philadelphia, Dorothy Moore-Duncan, will consider both sides' briefs, along with several thousand pages of hearing exhibits and transcripts involving 18 witnesses.

Moore-Duncan initially denied the union's petition without a hearing last January, but was ordered to hold the hearing after the doctors appealed to the NLRB's Washington headquarters. If she rules in favor of the doctors this time, it would set a national precedent, allowing a union election and then collective bargaining with the HMO.

It also would trigger a flood of physicians contacting unions, labor officials predict. Just 3 percent of U.S. doctors -- nearly all of them hospital employees -- are unionized.

U.S. antitrust law prohibits independent contractors from banding together to set prices and terms for their work, but NLRB has allowed unions for some whose work primarily is dictated by others, including entertainers, athletes, cab drivers and, most recently, couriers.

Antitrust lawyers, though, call the case a long shot for the doctors, primarily because they supply their own offices, equipment and support staff.

AmeriHealth covers 270,000 New Jersey residents.