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INSURANCE PROPOSAL ASSAILED; FOUR CONGRESSMEN CHALLENGE WELLPOINT.

Byline: Ben Sullivan Daily News Staff Writer

Four members of the state's congressional delegation asked Wednesday that the Clinton administration reject a plan for WellPoint Health Networks to run the state's child health insurance program.

The legislators, in a letter to colleagues, said WellPoint should not be allowed to administer the program while also seeking business from it.

``It is an obvious conflict of interest to have a health plan both running and participating in the state program,'' said Rep. Fortney ``Pete'' Stark, D-Fremont, Rep. Bob Matsui, D-Sacramento, Rep. Henry Waxman, D-Los Angeles, and Rep. George Miller, D-Pleasant Hill.

The state will receive significant funding from a federal program allocating $24 billion over five years to states to cut the number of uninsured children. California is slated to get 20 percent of the money this year if the Clinton administration approves its child health coverage proposal.

As administrator, WellPoint would determine which children are eligible, then enroll them and collect premiums. Its Blue Cross of California health plan is also among those that will provide care to children.

Stark said WellPoint's dual role would let it steer healthy children into its plan while sending costly patients to competing plans but WellPoint said numerous ``fire walls'' have been built into its contract to prevent such conflicts, including recording all phone calls on patient assignments and keeping the plan's books open to third-party audit inspection.

``We were awarded this contract fairly,'' said WellPoint spokeswoman Cynthia Coulter. ``We competed for it, won it, have taken steps to ensure plenty of fire walls, so what do you want us to do?''

Stark said he might sue if the administration doesn't reject the contract.
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Title Annotation:BUSINESS
Publication:Daily News (Los Angeles, CA)
Date:Mar 5, 1998
Words:279
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