Blue Cross of California Drops All HMO Members in Napa County After Doctor Group Folds
Blue Cross of California has canceled its HMO plan in Napa County following the closure of a "major medical group," the San Francisco Chronicle reports. Blue Cross spokesperson Michael Chee said the company had "no choice" but to drop about 3,400 HMO members after Napa Valley Physicians, Inc. went bankrupt in March. Chee said, "There are no HMO doctors to contract with anymore. To my knowledge ... this is the first time we've pulled a product out of a county due to lack of network. There's simply no supply for the product." Under state law, insurers are required to offer a plan "only if the number of physicians who accept it meets a specific doctor-patient ratio." The Department of Managed Health Care cannot tell insurers where to operate but can "require them to make sure people's health care is not completely disrupted." Blue Cross is suggesting that patients switch to its less restrictive, more costly PPO plan. The insurer will continue to cover patients and pay doctors through a transition period ending Oct. 1. Meanwhile, Blue Cross has applied to the state to cancel its HMO plans in Tehama and Shasta counties, which have more than 10,000 members combined. According to Blue Cross, San Ramon-based Hill Physicians Medical Group is expected to close next year and "leave the plan without a network of physicians" (Colliver, San Francisco Chronicle, 7/26).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.