CorVel Corp. had a right to remove a California doctor from its workers compensation medical provider network after the doctor failed to respond to utilization and peer review requests for unauthorized treatments, a California appellate court has ruled.

Dr. Douglas Roger, an orthopedic surgeon, was added to Irvine, Calif.-based CorVel's provider network in 2006 at the request of Ralph's Grocery Co., court records show. He often prescribed treatments for patients that were not recommended under California's workers comp medical treatment schedule, including ointments with capsaicin and Theramine tablets, described as "medical food" for seriously ill patients.

Dr. Roger prescribed such treatments more than 90 times after joining CorVel's network, and each of the treatments was denied payment by CorVel, records show.

CorVel had physicians contact Dr. Roger for independent peer reviews regarding his unauthorized treatments, records show. But Dr. Roger often did not return their calls, citing that he did not have immediate access to the patients' records at the time of their calls.

Dr. Roger was terminated from CorVel's network in 2007 after he failed to respond to several peer review requests for several patients, records show. Despite a formal protest letter from Dr. Roger saying he was denied due process in his termination, as well as attempts by both parties to resolve the dispute, Dr. Roger sued CorVel later that year for breach of contract.

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He also argued that CorVel terminated him because he prescribed unauthorized treatments that he thought were best for his patients, rather than because he failed to follow provider network policies.

In a unanimous unpublished decision on Thursday, California's 4th District Court of Appeals found that CorVel had a right to terminate Dr. Roger.

The court found that CorVel's network contract did not preclude Dr. Roger from prescribing lawful treatments that did not fit under California's treatment schedule, records show. It also found that CorVel failed to follow a three-step termination process laid out in the company's utilization review agreement.

However, the court declined to recognize Dr. Roger's contract breach claim. In its ruling, the court said Dr. Roger's termination was "inevitable" because he repeatedly failed to follow CorVel's procedures and did not take advantage of several attempts to justify his prescriptions, records show.

The “termination was procedurally fair,” the ruling reads. CorVel “gave Dr. Roger every chance to work out a resolution short of termination. That eventuality was never concealed or downplayed and CorVel gave Dr. Roger plenty of notice and abundant opportunity to be heard.”