OHIO: 35,000 On Medicaid Leaving Insolvent HMO
More than 35,000 Ohio Medicaid recipients will be disenrolled from Cleveland-based Personal Physician Care HMO, "an apparent precursor to liquidation of the failed" health plan, the Cleveland Plain Dealer reports. The enrollees will be switched back to the state's fee-for-service Medicaid plan, allowing "them to seek care from any doctor or hospital that will see them." More than 30,000 the subscribers reside in Cuyahoga County, where Medicaid HMO membership is mandatory. They will have "an undetermined amount of time to choose a new HMO," the Plain Dealer reports. In Lorain, Mahoning and Trumbull counties, where about 4,800 enrollees reside, joining an HMO is voluntary. The insolvency will also affect about 8,000 commercial HMO customers. According to an audit conducted by state insurance regulators, "PPC's liabilities exceeded its assets by $15.9 million at the end of 1997." Jon Allen, spokesperson for the Ohio Department of Human Services, said, "PPC's contract ... was due to expire at the end of September anyway. Because of their fiscal condition, and because the insurance department has indicated to us a sale of the plan is unlikely, we believe it's in the best interest of the plan members to disenroll." The Plain Dealer notes that under state law, an HMO must provide services to its members for 30 days after liquidation (Solov, 8/20).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.