> there should be some consequences for someone acting as a "doctor" testifying in a court case and having very little clue what was going on, but choosing to testify.
It will make no difference. It is the people higher up and the investors in the company who are responsible. The doctors in question don't behave as they do just because they want to, they do it because that is what the company that employs them demands.
What kinds of complaints warrant a formal investigation?
In general, any complaint that would warrant disciplinary action if
substantiated (e.g., sexual misconduct, gross negligence and/or
incompetence, etc.) is referred for investigation. Other kinds of
complaints may also require a formal investigation. These include physician
impairment, unprofessional conduct and unlicensed practice issues.
I thought similarly when reading the part of the article where the legal team said that Cigna's policy wasn't illegal. Maybe it isn't against any laws for the company to do it, but isn't it unethical for doctors to do it? If the law requires that licensed doctors be the ones to review the claims, maybe the most effective way to change this practice is for medical boards to start sanctioning doctors who do this.
It will make no difference. It is the people higher up and the investors in the company who are responsible. The doctors in question don't behave as they do just because they want to, they do it because that is what the company that employs them demands.