Fresno County Steps Into Medi-Cal, Healthy Families Contract Talks
On Tuesday, Fresno County supervisors agreed to help resolve a nine-month contract dispute between Children's Hospital Central California and Anthem Blue Cross because of concerns that the dispute is limiting children's access to care, the Fresno Bee reports.
The contract between Children's and Blue Cross ended Aug. 1, 2007, when they failed to come to an agreement on payments for children who receive Medi-Cal and Healthy Families benefits through an Anthem Blue Cross plan. Medi-Cal is California's Medicaid program, and Healthy Families is California's version of the State Children's Health Insurance Program.
Hospital officials said they lost $11 million on the Blue Cross contract in 2006.
Dozens of Hmong and other immigrant parents told county supervisors that since the contract was terminated, they have had to seek care for their children out of town or wait months for approval to see a specialist.
The county supervisors ordered Edward Moreno, the county's health director, to develop a plan so the county can ensure the children have access to care. Supervisors also ordered a legislative hearing to discuss health care issues, including the contract dispute.
Stan Rosenstein -- chief deputy director of the Department of Health Care Services, which oversees Medi-Cal -- said county officials contacted him and he has had discussions with the hospital and Blue Cross. He said he cannot "force a resolution of one party or another."
Tim Curley, director of community and government relations for the hospital, said Children's is confident negotiations are progressing.
Leslie Porras, a Blue Cross spokesperson, said that the negotiations were "very positive" and that the health insurer is "hopeful that we can reach an agreement here soon" (Anderson, Fresno Bee, 5/6).