State Rejects Request To Hold Hearings on CalPERS’ Plan To Drop Hospitals From HMO Network
The Department of Managed Health Care will not hold public hearings on CalPERS' plan to drop coverage at 38 hospitals before deciding whether to approve the move, agency officials said Friday, the Sacramento Bee reports (Rapaport, Sacramento Bee, 7/17). CalPERS in May voted to drop 38 of the most costly hospitals from its Blue Shield of California network beginning in 2005 in an effort to control premium rate increases. The group said an analysis by Blue Shield indicated some of the hospitals being dropped had proposed rates for 2005 that exceeded the statewide average by as much as 80%. The move to drop the hospitals is expected to save CalPERS $36 million in 2005 and $50 million annually in the following years. Members whose providers are dropped from the network will be able to enroll in one of two preferred provider plans offered by CalPERS to avoid switching physicians or hospitals. Last week, Sen. Deborah Ortiz (D-Sacramento) asked DMHC Director Cindy Ehnes to hold a public hearing before ruling on Blue Shield's application to drop the hospitals (California Healthline, 7/13).
Before making its decision, DMHC must determine whether the plan would compromise patients' access to hospitals and doctors. In a letter to Ortiz, regulators said a public hearing would delay the department's decision, which is due by July 29. Members of the public can still voice their opinions on the plan by e-mailing or writing to DMHC, according to the Bee (Sacramento Bee, 7/17).
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