UMC issues warning to HMO

Art Nadler

Tuesday, Jan. 5, 1999 | 11:03 a.m.

About 7,500 PacifiCare customers could be scrambling for a new doctor if University Medical Center and the health maintenance organization don't settle their contract disputes.

William Hale, chief executive officer at UMC, told the hospital board of trustees Monday that PacifiCare of Nevada had terminated primary-care physician agreements with UMC's 10 Quick Care Centers on Jan. 1. Hale said he saw the lack of an agreement as a breach of contract with the hospital and was putting the HMO on notice.

UMC has given PacifiCare 20 days to settle contract disagreements or the health maintenance organization's patients who also go to the hospital will have to pay full price.

"We average 15 in-patients a day from PacifiCare at UMC," Hale said. "Now (after 20 days), they will pay full price when they come to the hospital. This is very upsetting. I felt we had a good partnership with PacifiCare."

Kayla Callas, director of public affairs and regulatory compliance with PacifiCare, would not comment on why the HMO terminated its agreement with UMC's satellite Quick Care Centers. But she said patients seeing primary-care physicians at the centers -- nearly 7,500 -- could continue to do so throughout January.

The HMO has a customer base of about 68,000 people statewide.

"If it comes down to a date (for the hospital agreement), we have contracts with other hospitals," Callas said of the pending deadline. "We are working with our members to ensure that there is minimal disruption."

Callas said PacifiCare currently has contracts with Valley Hospital Medical Center, Desert Springs Hospital, Summerlin Hospital Medical Center and Lake Mead Hospital.

PacifiCare, Callas said, has set up a toll-free telephone number to assist customers who are seeing primary-care physicians at Quick Care Centers. It is 1-800-264-9017.

UMC, in a letter to PacifiCare on Monday, stated that disagreements needed to be resolved by Jan. 25 or the hospital's agreement with the HMO would be terminated on Feb. 4.