NevadaCare raises reimbursement for obstetricians

Friday, May 10, 2002 | 9:53 a.m.

Nevada's largest health maintenance organization for Medicaid patients informed the state that it will significantly increase reimbursement to obstetricians for prenatal care and delivery services.

The news from NevadaCare Inc. of Las Vegas, which covers about 45,000 Medicaid members statewide, comes on the heels of media reports indicating local OB/GYNs are refusing to accept new patients because of the medical malpractice insurance crisis. Medicaid is a government-funded program that serves low-income families.

NevadaCare, which has 111 OB/GYNs under contract, is also hoping to meet with them by the end of next week to discuss possible ways of eliminating some of the red tape that goes with processing insurance claims. One possibility is that doctors will not need as many pre-authorizations from NevadaCare in order to perform routine medical services.

"We're probably two to three weeks down the road from implementing this," Todd Meek, NevadaCare president and chief executive officer, said. "We are putting out calls to our contracted OB/GYNs to hold a task force meeting. We understand what they're going through right now."

In a prepared statement, Gov. Kenny Guinn said that "this rate increase will help with the rising costs these doctors face."

"There isn't a quick or simple solution to the current question of access to care or the malpractice insurance crisis," Guinn said. "However, we will continue to work to resolve this issue impacting Nevada's families. Women should not have to worry that their doctors will turn them away."

Charles Duarte, administrator of Nevada's Division of Health Care Financing and Policy, said Thursday that the improvements NevadaCare has proposed on behalf of physicians have been successful in other states.

"It's a positive step for them to increase the reimbursement," Duarte said.

Meek declined to divulge the percentage of reimbursement increases his company is prepared to make.

"Our slogan has been that we were going to reduce the hassle factor for the physicians," Meek said. "Managed care has a number of hoops folks have to jump through and we're trying to reduce that."