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Doctors group, HMSA
By Harold Morse
disagree over fees
Star-BulletinA hearing into Hawaii Medical Service Association reimbursement of physicians will resume at 10:30 a.m. Tuesday in the Department of Commerce and Consumer Affairs hearing room.
Dr. Arleen Jouxson-Meyers, president of Hawaii Coalition for Health, yesterday said HMSA promises patients some services that HMSA does not adequately compensate physicians for.
She said HMSA has a large share of the medical insurance market here and substantial economic power over physicians who have no choice but to participate with HMSA.
But Ellen Carson, HMSA attorney, made numerous objections to Jouxson-Meyers' testimony. A few times, Wayne Metcalf, state insurance commissioner, recessed the hearing to consider Carson's objections with his own attorney.
As adjudicator, Metcalf overruled the objections and allowed Jouxson-Meyers to proceed. She started to give specific case examples of what she was talking about, but time ran out and Metcalf recessed proceedings for the day.
Cecelia Chong, an investigator with the state Insurance Division, gave an overview of complaints filed against HMSA by the coalition and individuals, along with related documentation.
Asked later what she thought of the hearing so far, HMSA's Carson said, "We believe the whole process is fundamentally flawed."
HMSA said in a news release it is obligated to look after interests of its members as health care consumers. Its physicians contracts remain in place and members continue to have full benefit coverage, HMSA said.
HMSA said it disagrees with claims physician reimbursements are inadequate, unfair or adversely affect health care.
"However, should any state officials have these kinds of concerns, the solution is not to micro-manage the private agreements of HMSA or any health plan," said Fred Fortin, HMSA vice president.
