Medicare, Medicaid stable in Nevada

A national trend of managed care organizations dropping Medicare and Medicaid patients has not spread to Nevada, state health-care officials said Monday.

Higher federal and state requirements, while reducing fee reimbursements, is being blamed for HMOs pulling out.

So far, 12 states including New York, New Jersey, Florida, Massachusetts and Connecticut have seen their Medicare and Medicaid programs abandoned.

"We have gotten very good commitments from HMOs in Nevada," Janice Wright, deputy administrator for the state Division of Health Care Financing and Policy, said in comparison. "Managed care has indicated a willingness to work with us."

Beginning Oct. 1, Medicaid patients throughout the state will be required to abandon their present fee-for-service system -- where they chose a doctor of their choice -- and sign with HMOs.

Wright said there are several health-maintenance organizations already doing voluntary Medicaid managed care throughout the state.

The Health Care Financing Administration is presently monitoring HMOs across the nation.

Liz Foley, director of HCFA's Medicare Health Plan Operations on the West Coast, said Medicare-managed programs in Nevada are stable.

PacifiCare, the third largest HMO in the nation, has decided to drop its Medicaid services. Kayla Callas, director of public affairs and regulatory compliance, said the corporation never had a Medicaid program in Nevada.

Callas said PadifiCare is currently evaluating its Medicare-managed care program, which has been in existence since November 1991.

As of March 31, PacifiCare had 24,355 seniors enrolled in Medicare-managed care programs.

(((The New York Times contributed to this story.)))

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