MEDICARE HMOS: Bill Would Require Senior Coverage
Hoping to lure HMOs into insuring Medicare beneficiaries in rural areas, California's Senate Appropriations Committee approved 5-2 a measure that would require HMOs maintaining contracts with any state program, such as Medi-Cal or CalPERS, to offer Medicare coverage in the same county, the Chico Enterprise- Record reports. Several HMOs revoked their Medicare plans last year upon finding federal reimbursements for care in rural areas inadequate -- a move that "hit seniors' budgets hard." However, committee member Tim Leslie (R-Tahoe City), although he voted for the bill, expressed hesitation, saying it could prompt the loss of any remaining HMO coverage in rural areas. The California Association of Health Plans also opposes the legislation, writing to bill sponsor state Sen. Jackie Speier (D), "This bill could force health plans to chose between offering Medicare coverage in counties with inadequate reimbursement rates or where the plan has difficulty maintaining an adequate provider network and dropping its contract or reducing its service area within the relevant state program." SB 169 will be considered by the Senate next week.
In related news, SB 1181, a bill requiring HMOs to apply to the Department of Corporations for permission to drop a Medicare plan is expected to be considered by the Appropriations Committee soon (Mitchell, 5/19).