Hospitals Sue CalOptima, Pacific Health Over Unpaid Medi-Cal Claims
Eight southern California hospitals have filed a lawsuit against CalOptima and Pacific Health for failing to pay more than $1.2 million to reimburse care provided to Medi-Cal patients from July 2006 to 2008, the Orange County Register's "Healthy Living" reports.
CalOptima is Orange County's Medi-Cal managed care plan. CalOptima contracts with Pacific Health and two Pacific-owned hospitals to pay some claims for CalOptima patients.
For many of the unpaid claims, Pacific Health argues that CalOptima is liable for the payments while CalOptima counters that Pacific Health is responsible, the complaint says.
The complaint also charges CalOptima with negligence for contracting with Pacific Health, which had serious financial problems before the contract.
The hospitals did not disclose the total sum they are seeking from the insurers, but said it includes interest and attorneys' fees (Muir, "Healthy Living," Orange County Register, 6/5).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.