APA wants to put member and patient complaints against managed care on a "fast track" for legal action.

Last month the Association established the Office of Special Counsel (OSC) to strengthen the organization's commitment to a proactive litigation strategy.

The OSC will be directed by Jay B. Cutler, who is director of the APA Division of Government Relations.

Deputy Special Counsels for the office include Katherine Becker, J.D., Mara Osman, J.D., Cathleen Brady, J.D., and Eugene Cassel, J.D. Heather Whyte will serve as the OSC's legal assistant.

The OSC provides a mechanism by which complaints that are worthy of legal action can be "fast tracked," Cutler explained.

The Office will actively seek out complaints about managed care from psychiatrists and patients, and assess those complaints with a "critical legal eye," Cutler told Psychiatric News.

Complaints that have a sound "legal theory" for filing a suit will be forwarded to the APA Committee on the Use of the Litigation Fund, chaired by APA President Harold Eist, M.D.

"Legislative and market driven cost-cutting reforms have resulted in uncharted legal issues affecting psychiatrists and their patients," Cutler told Psychiatric News.

Complaints have been pouring into various components of the Association, but there has not previously been a discrete body with the special charge of bringing complaints hastily to the Board of Trustees for legal action.

"The staff of the OSC will combine legally astute and judicially sophisticated expertise in a range of areas_litigation, legislation, and regulation_for aggressively advancing the interest of APA members and patients," Cutler said.

The OSC will complement_but not substitute for_the expertise already provided by APA General Counsel, the Judicial Action Committee, and the Council on Psychiatry and the Law.

Member Demand

APA Medical Director Melvin Sabshin, M.D., emphasized that the new office was established in response to member demand.

"Our members have strongly urged us to consider, participate in, and initiate lawsuits that can visibly and rigorously defend against any inappropriate intrusion into the practice of psychiatry, as well as manage an aggressive, proactive legal initiative to protect patients' medically necessary psychiatric treatment," Sabshin said.

"Active involvement in the judicial system through this new office will add to our efforts to enhance the quality of psychiatric care, protect patient interests, and ensure fairness to psychiatrists," he added.

APA President Harold Eist, M.D., told Psychiatric News that he believes the new office will help expedite action against the most destructive practices of managed care.

The OSC will track and monitor the practices of managed care companies and forward information to the Committee on the Use of the Litigation Fund, which Eist chairs. In this way, complaints can be brought directly to the Board of Trustees, Eist said.

"We need to demonstrate to the public, to APA members, and to other professional medical organizations that we will take action to oppose these unjustified profit-driven tactics, which are injurious to our patients and destructive to our profession," Eist said. "We cannot allow medical necessity to be determined by the bottom line."

The message behind the OSC, said Eist, is "Enough is enough!"

He added, "As the public hue and cry about managed care reaches a crescendo, we want the public to know we are going to forcefully and rigorously defend their right to high-quality medical care. Otherwise, the public will see us as not having stood up in a time of need.

"No professional organization can tolerate a loss of its public credibility," Eist said.

(Psychiatric News, March 7, 1997)