CMA: Says DOC Should Make HMOs Pay FPA’s Bills
Making good on its promise to pursue payments the bankrupt FPA Medical Management Inc. owes doctors, the California Medical Association will ask state regulators this week to hold HMOs responsible for the bills. The Orange County Register reports that the 35,000-member CMA "said it will petition the Department of Corporations to enforce a law that doctors say holds HMOs responsible for ensuring that they receive payment for medical treatment delivered." The CMA estimates that doctors are owed $60 million statewide by the bankrupt FPA. Some doctors have had to pay out-of-pocket for services provided to FPA enrollees, according to the Register. The managed care industry says the CMA is barking up the wrong tree in contending that HMOs and not the physician-management company is responsible for the payments. "The CMA is saying that we are supposed to pay twice," said PacifiCare Health Systems spokesperson Cathy Batteer. The Register reports that the DOC has 30 days to respond to the petition, which "could lead to a hearing by an administrative-law judge and could be a first step toward" the CMA filing suit against the DOC (11/14). Click here to read about the CMA's other petitions to the DOC.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.