Dumped by Insurer, Los Al Hospital Owner 'Puzzled' by Breakup

Officials from a company that owns six hospitals in Los Angeles, Orange and Riverside counties -- including Los Alamitos Medical Center  -- said today they were “puzzled” by the decision of health insurance-provider Health Net Inc. to stop covering services at its hospitals.

Health Net announced Thursday it will stop covering patients' medical and health services at the hospitals run by Tenet Healthcare after contract negotiations broke down.

But Tenet officials issued a statement saying they were unaware of any contract disputes.

“Over the past several months, we have been working with Health Net to renegotiate the terms of our managed care contracts at six of our hospitals in Southern California. At the time of our last meeting, we were in full agreement on the terms of our co­ntract,” according to the statement.

“It is unclear to us as to why Health Net issued a contract termination and publicly released inaccurate information.”

At issue are reimbursement rates for health and medical services. Health Net officials said Thursday the company wanted reimbursement rate increases to be tied to the Consumer Price Index, which averages about 3 percent, according to the company. Health Net also wanted Medi-Cal reimbursements to be tied to state and federal funding for the program. The hospital system was pushing for higher reimbursement rates, according to Health Net.

Health Net's Western Region Health Plan President Steve Sell said Thursday the company had no choice because “Tenet Healthcare has refused our requests to negotiate a new contract that more accurately reflects current statewide market conditions.”

“Our goal is to help preserve affordable benefits for our customers, not pass along inflated health care costs,” Sell said.

The affected hospitals include Desert Regional Medical Center in Palm Springs, Fountain Valley Hospital and Medical Center, John F. Kennedy Memorial Hospital in Indio, Lakewood Regional Medical Center and Placentia Linda Hospital.

Health Net officially stopped covering health and medical services at the six hospitals at midnight Dec. 21, when a three-year contract expired.

 “We are puzzled and disappointed by their public comments,” according to Tenet's statement.

“Our patients remain our top priority and we will do all that we can to ensure they continue to receive the high-quality health care they have come to expect from our Southern California hospitals.”

-- City News Service