PacifiCare fined $50,000 for failing to comply...

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PacifiCare fined $50,000 for failing to comply...

Postby Webmaster » February 25th, 2005, 10:57 am

Oregon Health Forum, March 1999
http://www.healthforum.org

PacifiCare rebounds with $2.4 million in 1998

While announcing its new-found success, the company was fined $50,000
for failing to comply with state standards.

In 1997, PacifiCare of Oregon's net income stood at $3.8 million in the red. Its CEO, Bart McMullan, MD, was fired, along with with finance director Mark Charpentier. Then Pacificare rounded out 1998 with an operating profiit of $2.4 million and an investment portfolio valued at $5 million, according to Steve Lynch, vice president of public affairs. But its success was blemished by a $50,000 fine from Oregon's Department of Consumer and Business Services for problems with claims handled by physician groups. Specifically, PacifiCare failed to acknowledge or pay claims within 20 working days, denied claims without conducting a reasonable investigation and didn't send patients a written explanation of 67% of denied claims.
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