KERN COUNTY: Seniors Concerned About Medicare HMO Pullouts
Many Kern County seniors are worried about HMOs leaving the Medicare market, according to concerns raised yesterday at two forums sponsored by PacifiCare of California. President Brad Bowlus assured county residents that they need not worry about PacifiCare's Medicare HMO, Secure Horizons, pulling out of the Medicare market "since reimbursement rates are higher here than in neighboring counties." However, Bowlus cautioned seniors that changes in Medicare will prevent enrollees from switching plans as often. "When you enroll ... it's critical you consider all options," he said. Other concerns raised by the 750 local residents who attended the Bakersfield forums included the right to choose one's doctor and medicine and to challenge denials of care. The Bakersfield Californian reports that Secure Horizons Medical Director Dr. Richard Weiss told seniors "they can appeal medical decisions made at the doctor- patient level." And Secure Horizons pharmacist Dr. Mark Shinmoto explained that drug formularies add and remove drugs "as new medications are introduced and render old medications obsolete," but that seniors "can seek special permission to obtain" drugs that are not on the list. Officials also assured seniors that doctors don't receive incentives for not referring patients to specialists and don't face time limits for meeting with patients (Bedell, 11/19).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.