News in brief - Jan. 15, 2001

Mich. HMO drops internists as primary care physicians - Highmark doles out generic samples - Maine delays new drug plan - Payments to start from bankrupt hospital chain - Governor appeals to fix TennCare - Most jobs still offer insurance - CalPERS doubles deductibles

Mich. HMO drops internists as primary care physicians

Care Choice, a Muskegon, Mich., HMO, has sent letters to at least 740 Michigan patients telling them that their internists no longer will be considered primary care physicians and they must now select general practitioners or family physicians instead.

A Care Choice spokesperson said internists' utilization profiles more closely resembled those of specialists than those of other primary care physicians. Critics accuse the HMO of trying to rid itself of more expensive patients by disrupting their physician relationships.

Highmark doles out generic samples

The new pilot program by Highmark Blue Cross Blue Shield in Pittsburgh lets 100 physicians dispense up to 20 free generic drug samples a month to any patient, even those not covered by Highmark.

Highmark says the program provides an alternative to more expensive brand-name drugs, which are widely sampled.

Maine delays new drug plan

Maine officials say they will postpone implementation of their program to reduce prescription drug prices from Jan. 1 to April 1, to allow time to resolve pending litigation.

A recent ruling from a U.S. District Court temporarily prohibits the state from enforcing portions of the price-control measure. Maine is appealing that decision, and it is likely to be heard in March.

Payments to start from bankrupt hospital chain

Allegheny Health Education and Research Foundation, a defunct hospital chain in Pittsburgh, plans to begin paying 5,795 unsecured creditors this month, more than two years after it filed for Chapter 11 bankruptcy protection.

The organization owes creditors about $1.4 billion and has $150 million to pay them, including a recent settlement of a $52 million lawsuit against a consortium of lenders led by Mellon Bank.

Governor appeals to fix TennCare

Tennessee Gov. Don Sundquist is imploring the Legislature to save the beleaguered state managed care program for low-income residents. After a protracted session, TennCare was fully funded last year but faces expiration of its federal waiver at the end of 2001.

Sundquist said he would oppose letting the waiver expire to return to a traditional Medicaid fee-for-service program or allowing coverage reductions for children. But chronic budgetary problems in a state with no income tax will make it hard to keep the $5.2 billion program intact.

Most jobs still offer insurance

A survey by the Health Insurance Assn. of America finds that 74% of U.S. workers were offered health insurance coverage and 63% took it.

But it also found that 17 million workers do not have coverage and 13.6 million of those weren't offered coverage by their employers. Most of them were low-income workers, particularly part-timers.

CalPERS doubles deductibles

The California Public Employees' Retirement System will double deductibles and reduce drug benefits to shore up losses of its two self-insured plans.

CalPERS faces higher-than-expected utilization, especially of prescription drugs. As the state's second-largest payer after Medicare, with 1.2 million members, its actions are often copied by other payers in the state.