Business

California looking into United's administrative capacity

NEWS IN BRIEF — Posted April 23, 2007

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

The California Dept. of Managed Care is investigating whether UnitedHealth Group has sufficient administrative capacity to handle routine tasks such as loading contracts into its system in a timely manner.

The investigation comes after the California Medical Assn. filed a complaint with the department, which regulates health plans, and the California Dept. of Insurance. Aileen Wetzel, CMA's associate director in the center for economic services, said the association wants both agencies to confirm its belief, based on the 400% increase in members' complaints about the company since 2005, that United doesn't have sufficient administrative capacity to meet demand, one of the items established as a condition of the 2005 merger between UnitedHealth Group and PacifiCare Health Systems.

United spokesman Tyler Mason said the company was aware of the issues brought forth by the CMA and had assigned a staff member full time to address the contracting issues. Mason said the company would respond to the managed care department's request in writing.

Managed care department spokeswoman Lynne Randolph said the investigation was ongoing, and any decision that United had committed any violations could result in anything from a formal action plan to handle the administrative problems to fines and penalties.

The California Dept. of Insurance confirmed that it had received CMA's letter but would not comment.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2007/04/23/bibf0423.htm.

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn