Saint Agnes Sues PacifiCare, Community Medical Centers over ‘Conspiracy’ to End Contract
In an "anticipated" move, Saint Agnes Medical Center on Tuesday sued PacifiCare Health Systems and Community Medical Centers, alleging that the two entities "engaged in covert negotiations" to end PacifiCare's contract with Saint Agnes and "force the transfer of 61,000 HMO members" to Community, the Fresno Bee reports. PacifiCare announced on March 29 that it was cancelling its contract with Saint Agnes and its affiliated doctors group Matrix, citing its concern over the doctors group's financial health. In the lawsuit, filed in Fresno County Superior Court, Saint Agnes said PacifiCare ended the contract before its deadline, which the hospital maintains is at the end of the year. The lawsuit adds that the contract cancellation caused "confusion and anguish among patients, chaos in the managed care market in Fresno and Madera counties and disruption in the relationships between Saint Agnes and its patients and physicians." J. Michael Gallagher, executive vice president of corporate development for Saint Agnes, added that people enrolled in PacifiCare "because of Saint Agnes and its physicians. Patients are shocked ... the canceled contract took place." Calling the lawsuit "completely frivolous, born of unwarranted desperation," Community Medical Centers CEO Dr. J. Philip Hinton said that the medical center did not approach PacifiCare about a new contract. The Bee reports that the lawsuit could block PacifiCare from canceling its contract May 1. PacifiCare officials declined to comment on the lawsuit. Saint Agnes is seeking financial damages (Trujillo/Correa, Fresno Bee, 4/12).
In the meantime, hundreds of PacifiCare beneficiaries and their family members yesterday "registered concern, anxiety and anger" during meetings at California State University-Fresno and in Kingsburg about having to switch doctors and hospitals by April 23, the Bee reports. Although PacifiCare representatives tried to reassure beneficiaries, those assurances "fell short" as some people accused the MCO of "timing the changes so that patients could not switch" their health plans. PacifiCare officials told meeting participants that they will be able to find or be assigned to doctors before the contract change is complete (Steinberg, Fresno Bee, 4/12). Yesterday about 50 primary care doctors joined Sante Community Physicians, the doctors group affiliated with Community Medical Centers, a move that would allow about 80% of PacifiCare beneficiaries to remain with their physician, the Bee reports (Trujillo/Correa, Fresno Bee, 4/12).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.