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Biotech / Medical : MedPartners (MDM) -- Ignore unavailable to you. Want to Upgrade?

To: Northern Marlin who wrote (164)	11/23/1999 5:17:00 PM
From: FESHBACH_DISCIPLE	Respond to of 165

This does not look good Riverside, Calif., Hospital Sues Physician Management Company Douglas E. Beeman 11/19/1999 KRTBN Knight-Ridder Tribune Business News: The Press-Enterprise - Riverside, California Copyright (C) 1999 KRTBN Knight Ridder Tribune Business News; Source: World Reporter (TM) RIVERSIDE, Calif.--Riverside's Parkview Community Hospital claims MedPartners Inc., the troubled physician management company, shorted the struggling hospital $10 million in patient care funds and kept such poor records that the hospital never knew for sure which patients were eligible for care. The hospital, which has lost nearly $15 million over the last four years, sued MedPartners Thursday in Riverside Superior Court. Joel Weiden, a spokesman for Caremark Rx, the name MedPartners recently adopted, said the Birmingham, Ala., company could not comment because it had not seen the lawsuit. However, Weiden said MedPartners has "made a good-faith effort to resolve outstanding issues with all health plans, institutions and doctors ... and we will continue to do so until it's resolved." MedPartners owned and managed physician groups throughout Southern California, using a now-bankrupt subsidiary, MedPartners Provider Network, to act as a financial and managerial middleman between health plans and the doctors and hospitals who provided the care. Earlier this year, California's Department of Corporations seized control of the subsidiary and forced it to declare bankruptcy. State regulators said the subsidiary had depleted its cash reserves, and they were afraid it would pull out of the state without paying its bills. Most Southern California hospitals that dealt with MedPartners have tried to resolve unpaid bills through a settlement between the company and state regulators, said Jim Lott, spokesman for the Healthcare Association of Southern California. Under that settlement, MedPartners agreed to be responsible for valid debts and claims against it. "We were hoping that would be the process that would keep it together and get a good business solution for everyone," Lott said. But Rebecca Callahan, the Irvine attorney who represents Parkview, said the hospital no longer had a contract with MedPartners by the time the bankruptcy court intervened. According to the lawsuit, Parkview was supposed to provide hospital care to about 80,000 patients affiliated with Riverside Medical Clinic, which MedPartners formerly managed. The contract required Parkview to cover the cost of hospital care provided there and elsewhere. In exchange, the hospital got a flat monthly fee for each patient. MedPartners was supposed to regularly provide lists of eligible patients, and data on a variety of items, including payment claims and hospital services provided elsewhere, the lawsuit states. But MedPartners never provided an accounting for more than $8 million in out-of-area hospital charges, or an accounting of $3 million in monthly fees that the company claims it overpaid the hospital for patient care, the lawsuit alleges. The suit contends MedPartners never provided an up-to-date list of patients Parkview was responsible for, leaving the hospital to provide care to ineligible patients. Peter Gasperoni, a managed care consultant hired by Parkview Community Hospital, said the hospital is seeking $10 million in reimbursements from MedPartners. He said the hospital has tried since last year to resolve the dispute. MedPartners sold most of its physician practice management business this year to concentrate on prescription drug management programs. The company renamed itself Caremark Rx to reflect the change.