Prime Healthcare is pleading with the state to reverse CalOptima Health’s decision to terminate contracts with four of the company’s “safety net” hospitals serving Orange County’s poorest residents.
Since the contracts were terminated Monday, Feb. 5, physicians at Prime have reported prolonged, agonizing wait times for patients, the company’s president and chief medical officer said in a Friday letter to Dr. Mark Ghaly, California secretary of health and human services. In some cases, patients have walked out of emergency rooms in disgust and been refused transfers to other nearby CalOptima hospitals, wrote Dr. Sunny Bhatia.
“On behalf of patients, we ask that Department of Health Care Services hold CalOptima accountable to its responsibility to ensure access, continuity, and care to patients and include the safety net hospitals patients have relied on for decades,” states the letter. “These terminations are already negatively impacting patient safety, quality care, and outcomes for the vulnerable patients dependent on CalOptima, very literally putting their lives at risk.”
Ontario-based Prime operates 44 hospitals nationwide, including Garden Grove Hospital and Medical Center, Huntington Beach Hospital, La Palma Intercommunity Hospital and West Anaheim Medical Center.
In a statement Friday, Feb. 9, DHCS said Medi-Cal managed-care plans like CalOptima have the right to voluntarily terminate their contractual relationships with network providers with a 60-day prior notice.
Following termination of the Prime contract, the DHCS said, “emergency services and post-stabilization care continue to be covered” by the company.
CalOptima, which has 954,000 members and is the largest health insurer in Orange County, provides coverage to its members through three programs, Medi-Cal, OneCare, and the Program of All-Inclusive Care for the Elderly. Its contract with the four hospitals had been in effect for more than 15 years.
The termination of…
Read the full article here