The Columbus police union is suing the city over access to a doctor who specializes in sports, anti-aging and sexual medicine.
The Fraternal Order of Police Capital City Lodge filed the lawsuit after the city issued a memo to patients of Dr. Richard Cavender advising that all services rendered by Dr. Cavender will be excluded from the City of Columbus health insurance plan effective June 1.
According to court records, more than 200 people represented by the FOP receive treatment from Dr. Cavender.
Dr. Cavender operates the Cavender Health Center for Cardiometabolic Sports & Sexual Medicine in Westerville.
The FOP says the exclusion of Dr. Cavender from coverage would effectively deprive patients of their ability to receive medical care from him, as they would not otherwise be able to afford it.
Prior to the exclusion, Dr. Cavender was considered an out-of-network provider and insurance covered 70% of expenses.
No other doctor licensed to practice medicine in Ohio has ever been excluded from the city’s medical plan, according to the FOP.
According to court records, the decision to exclude Dr. Cavender came after a review of his use of testosterone injections conducted by the city’s health care administrator, United HealthCare Services.
The review suggested that 80% of health records reviewed did not support diagnosis to treatment, according to court records.
Dr. Cavender’s billing for lab tests done by a third party were also questioned by UHC. That issue was resolved when Dr. Cavender agreed to have the lab bill directly to the insurance company.
The lawsuit seeks a temporary restraining order against the city while a union grievance regarding the matter is settled.
Dr. Cavender responded to the lawsuit in a statement to NBC4:
In regards to United Healthcare’s review of medical records, 30 records were requested for an approximate three year period (June 1, 2011 to May 15, 2014). Nineteen (19) of the 30 records did not include the initial evaluation which is required to establish the diagnosis and the indications to initiate treatment for androgen deficiency, because this initial evaluation took place prior to the parameters of the records that were requested. At no time, has UHC or the City of Columbus requested additional information to clarify the absence of this initial evaluation nor has a peer to peer review (M.D. to M.D.) been conducted to discuss any questions or concerns relative to the diagnosis and treatment of Dr. Cavender’s patients, which is a standard process between insurers and health care providers when such questions arise.
In his role as a primary care physician, Dr Cavender coordinates patient care with associated medical specialists such as Cardiologists, Endocrinologists, Urologists, Gynecologists, Neurologists, Orthopaedic and Neurosurgeons, etc… in the complex management of illnesses associated with each patient. Dr Cavender’s diagnosis and treatment of patients has never been called into question by any specialist involved in the care of his patients.
Dr. Cavender has extensive experience, education, research and publications in the area of the evaluation and treatment of metabolic syndrome and the associated androgen deficiency in the male. He follows international standards and guidelines relative to the evaluation and treatment of these androgen deficient patients, specifically regarding the use of testosterone supplementation and replacement therapy as established in the Journal of European Urology, 2009 article, “Investigation, treatment, and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA, and ASA recommendations” by Wang C, Nieschlag E, Swerdloff R, Behre HM, Hellstrom WJ, Gooren LJ, Kaufman JM, Legros JJ, Lunenfeld B, Morales A, Morley JE, Schulman C, Thompson IM, Weidner W, Wu FC. (Eur Urol 2009;55:121– 30).
Dr. Cavender is not involved in any legal proceedings or grievance process between the Fraternal Order of Police Capital City Lodge and the City of Columbus. Dr. Cavender fully intends to comply with the decisions of the City of Columbus regarding how they choose to administer their health care plan. “