51.5 F
Laguna Hills
Thursday, Mar 28, 2024
-Advertisement-

PacifiCare to Offer Acupuncture, Chiropractic Coverage

PacifiCare, St. Joseph Skirmish in Court; Monarch Teams With CompCare

Alternative medicine has grown in popularity over the past few years in California, as well as other parts of the United States. Because of that fact, several healthcare service plans have had to decide whether to pay for such treatments.

Come Aug. 1, Cypress-based PacifiCare of California, a subsidiary of PacifiCare Health Systems Inc., Santa Ana, will cover some alternative medicine options for its commercial HMO patients. PacifiCare’s combination benefit, including chiropractic, acupuncture and traditional Chinese herbal supplements, is being provided by American Specialty Health Plans of San Diego.

American Specialty Health Plans is PacifiCare’s longtime chiropractic benefit provider. PacifiCare said it would offer the new alternative medicine benefit to its mid-size and large employer groups as a supplemental benefit. Members will have direct access to more than 2,200 credentialed chiropractors and more than 700 credentialed acupuncturists in California.

Five supplemental alternative medicine plans will be offered, with co-payments ranging from $5 to $15 and annual visit maximums ranging from 20 to 40. Costs vary by plan and employer group size.

PacifiCare, St. Joseph in Court

Orange County Superior Court Commissioner Sheila B. Fell set a July 26 date for a hearing in a contract dispute between St. Joseph Health System, Orange, and PacifiCare of California. Pending that hearing, Fell also issued a temporary restraining order stopping St. Joseph from refusing to provide coverage for all medically necessary services to selected PacifiCare of California members who haven’t been transferred to another provider.

St. Joseph, saying that it was losing $45 million on its health maintenance organization contracts, recently announced it would cease accepting any new HMO patients and is mulling cutting ties to all 17 HMOs it now contracts with. PacifiCare alleges St. Joseph is in breach of contract because of its actions.

The St. Joseph business units named on the temporary restraining order are St. Joseph Heritage Healthcare Foundation, St. Jude Heritage Medical Group, St. Jude Affiliated Physicians, Bristol Park Medical Group, St. Joseph Heritage Medical Group, St. Joseph Hospital Affiliate Physicians and Mission Hospital Affiliate Physicians.

Fell also ruled that “during the period of this order, PacifiCare of California shall continue to use its best efforts to contact the members and transfer them to other providers.”

Monarch, CompCare Join Forces

Monarch HealthCare, Mission Viejo, signed a contract with CompCare Group Inc., Walnut Creek, to establish a network to provide occupational health and workers’ compensation services in Southern California. Monarch HealthCare is an association of more than 700 physicians in private practice and is managed by Physician WebLink of California; its owners and operators care for more than 140,000 patients.

Under the agreement, CompCare Group will establish specialty provider networks with Monarch HealthCare. CompCare Group is also going to provide a secure, Web-enabled information system with focused case management teams for tracking and managing injured or ill employees’ continuum of care.

CompCare Group’s information system will, among other things, allow users to trend and benchmark illnesses and injuries across industries, help employers identify and eliminate risks and improve the safety of work environments.

Bits and Pieces:

Micro Therapeutics Inc., Irvine, amended its distribution agreement with Abbott Laboratories Inc., distributor of MTI’s peripheral blood clot therapy products. The agreement gives MTI’s direct sales force primary responsibility for marketing and sales, while Abbott retains responsibility for distribution and customer service Dietary supplement maker Roex Inc., Irvine, filed for an IPO, saying it hopes to raise up to $6 million. Roex’s products include Immortale for Men, purported to enhance male sexuality and vitality TriZetto Group, Newport Beach, and Jeff Margolis, its president and chief executive, won a silver Innovations in Healthcare award from the Adaptive Business Leaders Group, Tustin. ABL gave its platinum and gold awards to two companies not located in Orange County MedicineNet.com, Irvine, and IDG Books Worldwide collaborated to publish Webster’s New World Medical Dictionary. The dictionary, which MedicineNet.com said was written by its doctors and experts, comes packaged with a CD-ROM containing a fully searchable electronic version PacifiCare Foundation, Santa Ana, donated $10,000 to the American Heart Association’s Orange County chapter for heart disease prevention programs aimed at Latinos Orange County Blood Services, Orange, said it is critically short of all types of blood and is looking for donations. Orange County Blood Services supplies, among others, Irvine Medical Center, Chapman Medical Center, Fountain Valley Regional Medical Center and Western Medical Centers Dr. Burton Willis, a pediatrician who practices with Edinger Medical Group, Huntington Beach and Fountain Valley, was elected chairperson of the American Academy of Pediatrics’ California district.

Want more from the best local business newspaper in the country?

Sign-up for our FREE Daily eNews update to get the latest Orange County news delivered right to your inbox!

-Advertisement-

Featured Articles

-Advertisement-
-Advertisement-
-Advertisement-
-Advertisement-

Related Articles

-Advertisement-
-Advertisement-