Medical center will continue serving state workers/retirees

State workers, retirees and others with health insurance through Hometown Health Partners can, at least for now, relax: Carson Tahoe Regional Healthcare isn't pulling out of the plan.

The hospital and HHP are still battling over money. But hospital president Ed Epperson told the Public Employees Benefits board Thursday they will continue serving state employees and other Carson area workers covered by HHP while they work it out.

Hospital officials last month issued a notification they would cancel the contract effective March 15 because they believe HHP isn't paying them the amount of money they are rightfully entitled to under the contract signed in 2004.

That sent shock waves through the community of more than 4,500 state workers and retirees in the capital who feared they would have to drive to Reno for any future medical services.

Epperson told both the PEBP board and Gov. Jim Gibbons on Thursday they have agreed to honor that contract through Jan. 18 of next year - the request made by PEBP a week ago when the warring parties met with them. PEBP officials say the one-year period is required to cancel the contract.

Asking for assurances the issue wouldn't return, board member David Smith said, "I don't want to see in the paper tomorrow you're pulling out again."

"You have that commitment," Epperson said.

He said some of the issues between Hometown Health and the hospital have already been resolved and that they would work out the remaining problems without any interruption of service to those covered by the plan.

Hometown Health Marketing Director Ty Windfeldt also committed to working with Epperson and the hospital to resolve the problems.

But Epperson said he was somewhat concerned when told Thursday morning Hometown Health was suing the hospital. That suit has apparently been prepared but not actually filed.

Epperson said the problems began almost immediately after the contract putting them in with HHP was signed in July 2004. The hospital had tried to avoid that contract saying they were effectively being forced to accept an insurance program operated and controlled by their competition - Washoe Medical Center, now Renown.

He said the audit report by AON, which has been used by both hospitals and insurance companies, shows Carson Tahoe has been receiving a lower reimbursement rate for patient services than other hospitals signed up with HHP - primarily Washoe Medical Center.

He said Carson Tahoe's profits have fallen every year since that contract, mandating a 55 percent discount instead of the 25 percent they had been giving for state workers and retirees, started.

PEBP officials presented a report by Health Claims Auditors Inc. that contradicts Epperson's claims. That report says the allowable rates for Carson-Tahoe under the contract is 11 percent greater than the allowable rates for three other HHP hospitals.

Mary Walker, representing Carson Tahoe, told the board she disagrees with that conclusion and wants to review the report.

"We've for years relied on the AON data to determine what we were being paid versus other hospitals," she said.

And she said that data shows the medical center has been underpaid by HHP.

Epperson said they still have disputes with how HHP is handling the contract.

"However, our concerns will be dealt with in a manner that will have no impact on PEBP members," he said.

Gibbons said he was pleased the two managed to work something out.

"State employees and retirees located in the Carson City area should not be denied access to their local medical facilities," he said.

Epperson and Windfeldt committed to negotiate in good faith to resolve their differences.

• Contact reporter Geoff Dornan at gdornan@nevadaappeal.com or 687-8750.