Terminated Contract Won't Affect Health Care for West County Residents;
April 3, 2003
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Contra Costa health officials are advising West Contra Costa members of their health plan that even though the County has cancelled a contract with Doctors Medical Center in San Pablo, services will continue with no interruption.
Contra Costa Health Services terminated its contract with Tenet Healthcare, which owns Doctors Medical Center, this week because the hospital was charging inflated rates for services to Medi-Cal members of the Contra Costa Health Plan, which the county operates. Tenet Healthcare is being investigated by the federal government for overcharging Medicare patients and other irregularities.
"As a public agency, we have an obligation to tax payers to make the best use of funds for healthcare. Renewing this contract was not in the best interests of anyone," says William Walker, MD, Director of Contra Costa Health Services.
Walker says that before the county took the unusual step of terminating the Doctors Medical Center contract, which had been in place since 1994, it wanted to be sure health care services to West County patients would continue with no problems.
"We are pleased that Health Plan patients will continue to receive services at Doctors and the county will be able to save nearly $1 million," says Walker. "Tenet is required by law to treat all emergency patients and they have agreed to continue to provide routine care to Health Plan members. We don't expect our members who were served by Doctors to notice the difference."
According to Walker, services to Medi-Cal members of the Health Plan who are hospitalized at Doctor's will be reimbursed at a rate determined by the state. That rate will be considerably lower than what Tenet has been charging us under the contract we had with them. Almost seventy percent of the Health Plan's members are covered by Medi-Cal.
The County will also pay for services at Doctor's for non-Medi-Cal patients and that rate will be higher than the State-set rate.
Walker says there has been some confusion because Tenet was telling patients the county had eliminated a program called Basic Adult Care that provided health services to patients who were not eligible for MediCal.
"We actually replaced Basic Adult Care with a more expansive program called Basic Health Care. It provides care to all residents of Contra Costa County who are at 300% or below of the Federal Poverty level," says Walker.
The Health Plan advises members with questions about service at Doctors Medical Center to call Member Services at 1-877-661-6230.
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- William Walker, MD