Dispute between Cigna, Raleigh practice could affect patients

The impasse between Cigna and Ron Howrigon could affect the ability of thousands of patients to see physicians at the practice and what they pay for services.

"There's an old saying: When elephants fight, only the grass gets hurt," Howrigon said. "I think that's what's likely to happen here. Large insurance companies fight with doctors, (and) the patients are the ones who are going to get hurt."

Raleigh Neurology is one of the largest practices of its kind in the country, with 27 physicians, 280 employees and more than 250,000 patients. Howrigon's Fulcrum Strategies negotiates the practice's contracts with insurance companies, just as he does for about 1,000 physicians nationwide.

Years ago, Howrigon was on the other side of the table, representing insurers in contract negotiations.

"I started to feel like insurance companies had so many advantages," he said.

Cigna recently announced it would no longer deal with Fulcrum Strategies or any physicians represented by Howrigon, who has been critical of his former industry.

"If insurance companies stopped talking to everyone who said something unflattering about them, they'd live in a pretty lonely world," Howrigon said.

Cigna declined to comment on the move, issuing a statement that said it was a business decision and that the insurer would be "more than happy to work directly with doctors in Raleigh and elsewhere in North Carolina."

"I was surprised. I didn't see it coming," Howrigon said. "In some respect, I know Cigna doesn't like what I do."

Raleigh Neurology Chief Executive Stephen Smith said he's never seen anything like the dispute before.

"There's anger there, personal anger," Smith said.

Dr. Bill Ferrell, president of the practice, said he and his partners are frustrated, especially for their patients.

"Some of those (physicians) may not be available, which leads to great inconvenience to patient access," Ferrell said.

"They build that relationship with our physicians. Then, all of a sudden, they can't come see that physician. It's very difficult on the patient," Smith said.

"It seems a little surprising that they would take this tack, trying to eliminate something that's helpful to us as a group," Ferrell said.

Howrigon said Cigna is trying to drive him out of business so they won't have to deal with him anymore.

"They weren't getting their way with every doctor they wanted to, and it was annoying them," he said. "So they, like one would swat away a fly, (say), 'Stop working with him. Make him go out of business.'"