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FOR RELEASE: August 26, 2002
State Health Commissioner Denies License Renewal for AmCare Health Plan
State Health Commissioner Dr. Leslie Beitsch has denied the license for AmCare Health Plan of Oklahoma, Inc. to operate a health maintenance organization (HMO) in the state. The license denial is effective October 1, 2002.
After September 1, AmCare will have fewer than 4,000 members remaining. Beitsch said the state health department expects AmCare to assist each of its employer groups with getting other coverage. Also, AmCare will identify pregnant members to coordinate their care.
In a consent order signed on August 20 by the Commissioner of Health and AmCare, the HMO agreed to continue only limited operations for the purpose of winding down its business in Oklahoma. As of July, AmCare had nearly 40,000 Oklahoma members.
“We are working to make sure that AmCare members get necessary health services during this transition period. We expect that most, if not all, will be covered under other health plans or insurance by October 1," Beitsch said.
AmCare members who cannot find a doctor or who have been contacted by a collection agency should call AmCare’s Customer Service office at 1-800-772-2993. During the wind-down period, the state health department will require AmCare to continue locating doctors and handling bills for members.
AmCare members who want to file a written complaint or need assistance with other problems can contact the state health department. A complaint form is available on the Department’s Web page at www.health.state.ok.us. A complaint form can also be obtained by calling (405) 271-6868 or by leaving a voice message at 1-800-811-4552.
Beitsch said that most of the health care providers are complying with clauses in their contracts with AmCare that bar the providers from billing members for anything but copayments. “If a health care provider is billing an AmCare member, the member should contact AmCare. If the provider keeps billing the member, the member should contact the state health department,” he said.
"Members are our first priority, but we also want to assure that doctors, hospitals and other health care providers who serve members get paid by AmCare," Beitsch emphasized. Recent financial statements show that AmCare may owe Oklahoma health care providers as much as $16 million. The consent order signed by AmCare requires that it submit a plan to settle all unpaid claims.
Doctors, hospitals and other providers need to file claims with AmCare as soon as possible after any services have been provided to AmCare members. There is no official cut-off date, but the earlier claims are filed, the sooner AmCare will know how many claims need to be paid.
Although most of AmCare’s members are enrolled through employer groups, some 36 members are covered under individual contracts. “We don’t want those 36 people to be left without coverage, but some of them may have unique circumstances that will make it harder for them to find another health plan,” Beitsch said. He advised those individuals to contact AmCare as soon as possible for assistance in finding other coverage.
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