MAXICARE CUTS MEDICARE THOUSANDS OF SENIORS MUST FIND NEW PLAN.Byline: Evan Pondel Staff Writer Los Angeles-based Maxicare Health Plans Inc. is pulling the plug on its Medicare product, MAX 65plus, as the HMO HMO health maintenance organization. HMO n. A corporation that is financed by insurance premiums and has member physicians and professional staff who provide curative and preventive medicine within certain financial, option for about 7,700 seniors in Los Angeles and Orange counties will be eliminated Aug. 31. Maxicare, with 254,000 members in California, said the decision follows the company's request for mutual termination of its Medicare contract with the Centers for Medicare and Medicaid Services The Centers for Medicare and Medicaid Services (CMS), previously known as the Health Care Financing Administration (HCFA), is a federal agency within the United States Department of Health and Human Services (DHHS) that administers the Medicare program and , or CMS (1) See content management system and color management system. (2) (Conversational Monitor System) Software that provides interactive communications for IBM's VM operating system. . CMS said it terminated its contract with Maxicare because the managed health care group was unable to pay its bills and provide sufficient care for its members. While officials from Maxicare were unavailable for comment, Leslie Porras, a spokeswoman from an outside public relations public relations, activities and policies used to create public interest in a person, idea, product, institution, or business establishment. By its nature, public relations is devoted to serving particular interests by presenting them to the public in the most firm representing the company, said letters have been sent to members regarding the termination. Porras also said the letter informs members they will have to make other choices in terms of insurance plans. ``We will work with our members to provide seamless transition to other plans to ensure continuity of care to all our members, with special emphasis on those that are currently in treatment,'' said Susan Blais, chief operating officer Chief Operating Officer (COO) The officer of a firm responsible for day-to-day management, usually the president or an executive vice-president. and executive vice president of Maxicare. Maxicare's move isn't a surprise to the health care industry, as the company has suffered a bout of financial woes in recent months. On May 25, the company announced that its California managed health care subsidiary filed for Chapter 11 bankruptcy protection. The filing was declared shortly after the California Department of Managed Health Care seized control of the health plan due to concerns about its ability to provide quality services and its financial solvency, according to Ivan L. Kallick, a partner with Manatt, Phelps & Phillips. Kallick, who represents the California Department of Managed Health Care, said the department claimed that Maxicare could not file for bankruptcy without a state-appointed conservator conservator n. a guardian and protector appointed by a judge to protect and manage the financial affairs and/or the person's daily life due to physical or mental limitations or old age. in place. However, Maxicare and the Department of Managed Health Care reached an agreement, Kallick said. ``The bankruptcy is moving rather smoothly,'' he said. ``The company, with the approval of the Department of Managed Health Care, is trying to sell its business in segments.'' With the company having about $60 million in cash, its decision to nullify nul·li·fy tr.v. nul·li·fied, nul·li·fy·ing, nul·li·fies 1. To make null; invalidate. 2. To counteract the force or effectiveness of. its Medicare product is part of an overall plan to ``unwind their business,'' Kallick said. Despite Maxicare's attempt to remedy its financial problems in California, the Indiana Department of Insurance filed a civil fraud lawsuit against the company. Though Maxicare has not operated in Indiana since the beginning of May, the Department of Insurance said the company did not have plans in place to cover health benefits 60 days after it discontinued operations Discontinued operations Divisions of a business that have been sold or written off and that no longer are maintained by the business. . However, Greg Thomas, chief deputy commissioner for the department, said Maxicare alleged it had a reinsurance The contract made between an insurance company and a third party to protect the insurance company from losses. The contract provides for the third party to pay for the loss sustained by the insurance company when the company makes a payment on the original contract. policy. ``So far we haven't received an answer on the complaint,'' he said. Out of the 87,000 Maxicare members in Indiana, 98.5 percent have been picked up by other HMOs and health care providers, Thomas said. As for Maxicare's outlook in California, the company could be sold in its entirety. ``Within 30 days there will be an announcement in terms of what entities will be buying Maxicare,`` Kallick said. |
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