ARBITRATION RECORDS. A California group has petitioned the state's Department of Managed Health Care in an attempt to make public all medical arbitration records.
The Foundation for Taxpayer and Consumer Rights and the Health Administration Responsibility Project formally asked the DMHC Feb. 13 to open all records dealing with health plan arbitration. Executive Director Jamie Court says a January study proves that health plans aren't meeting reporting requirements. California law requires health plans to report all arbitration cases to the state. However, that study's author concedes the report may not be accurate and likely didn't include complete data (see Feb. 12, page 3).
DMHC director Daniel Zingale says he agrees it's important to collect information about arbitration and to collect the correct information. But, he says, whether to disclose that information may be up to the governor and Legislature. State law, Zingale says, prohibits the DMHC from releasing any personally identifiable information.
PEDIATRIX TO BUY RIVAL. Pediatrix Medical Group, a PPM specializing in neonatology and maternal-fetal medicine, announced plans this month to acquire competitor Magella Healthcare Corp. of Frisco, Texas, for an estimated $190 million in stock and assumption of debt.
Pediatrix, of Fort Lauderdale, Fla., agreed to issue 6.8 million new shares of common stock to Magella shareholders and will set aside another 1.4 million shares for outstanding Magella stock options. Pediatrix also will repay $25 million in Magella bank debt with its existing credit facilities and assume $23.5 million in subordinated notes that could be converted into about 1 million Pediatrix shares.
The proposed transaction would give Magella shareholders a one-third stake in the new company, which will employ 460 physicians in neonatal intensive care units at about 185 hospitals in 27 states and Puerto Rico. Another 90 physicians will practice perinatology in some of the same markets,
according to Pediatrix.
The merger brings together "two very similar companies with very similar models," says Roger Medel, M.D., chairman and CEO of Pediatrix.
TENNCARE HMOS. Tennessee officials and lawmakers are stepping up their efforts to prevent the largest participating HMO from going ahead with plans to leave the state's TennCare Medicaid-style program by midyear, saying that the departure would cripple the beleaguered program.
BlueCross BlueShield of Tennessee, which operates the BlueCare HMO, confirmed this month that it is negotiating with top state officials, including Gov. Don Sundquist, to continue its participation in TennCare beyond its previously announced June 30 departure date. BlueCare provides coverage to 580,000 of TennCare's nearly 1.4 million low-income, disabled or otherwise uninsurable enrollees, including about 350,000 adults who would not qualify for Medicaid benefits.
Hoping to deter the Blues from leaving TennCare, state Sen. Roy Herron introduced several pieces of legislation that would raise taxes on BlueCross BlueShield and rescind the Blues' contracts to cover state and local government employees in Tennessee.
MONORAIL LINK. Doctors seeing patients at five downtown Indianapolis hospitals will find getting back and forth at work a bit easier and a bit more like Disneyland.
Clarian Health Partners, formed in 1997 from the merger of Methodist, Indiana University and Riley Children's hospitals, plans to break ground this spring on a $34 million, 1.5-mile monorail connecting its three facilities. The line also could ease traffic in and out of two hospitals not part of the Clarian group, Wishard Memorial Hospital and a Veterans Administration hospital two blocks away from the IU/Riley campus.
The line will replace a fleet of shuttle buses and help unify operations at the hospitals, where traffic frequently is congested and parking is often at a premium, says Douglas Zipes, M.D.
"This is really an absolutely essential aspect of what we're doing," says Zipes, director of cardiology at the Krannert Institute of Cardiology at Clarian.
AETNA NAMES CMO. Four months after the quiet departure of Arthur Leibowitz, M.D., Aetna has named a chief medical officer.
William Popik, M.D., will assume the post effective March 5. Popik, 55, most recently was senior vice president and national medical officer at Cigna. He will report directly to Aetna President and CEO John Rowe, M.D.
Before joining Cigna, Popik was senior vice president and chief medical officer of Health Net HMO California.
He received his medical degree from Columbia University College of Physicians and Surgeons and has a bachelor's degree in psychology from Yale University. He completed his residency in family practice at the University of California at San Francisco.
"(Popik) shares Aetna's philosophy that ultimate accountability must be local, yet the policies and procedures of medical management should share common goals and a standardized approach nationally," Rowe says.