Provider Law Likely Heading Back to Court

by Mark Friedman  on Monday, May. 5, 2008 12:00 am  

Lynn Weaks, CEO of Arkansas Surgical Hospital in North Little Rock, says the 41-bed facility won't be able to survive long term without higher reimbursement rates.

"I felt like she was very unfair toward those who were trying to participate in the hearings and leaned heavily toward the large insurance companies," Faris said.

(In 2006, Faris received a $2,000 campaign contribution from the Arkansas Medical Society, which wanted to testify during the hearings but wasn't allowed to.)

Faris said last week he was working out the details for holding a hearing.

He also said he was upset that Bowman didn't follow the advice of her chief counsel, Booth Rand.

While AWP allows insurance companies to vary pay rates to hospitals for cost and quality concerns, Rand couldn't find any evidence that the payments varied for those reasons.

Bowman told Arkansas Business last week that Rand didn't give her advice. She said Rand was the market examiner in the case, "and I agreed with some of his findings and disagreed with others."

Insurance carriers say health insurance premiums will rise if all hospitals are paid the same for the same procedures.

"One of our jobs as a payer is that when employers pay us money and buy insurance from us, they want us to help them to keep medical costs as low as possible," said Mike Stock, CEO and president of QualChoice/QCA of Little Rock. "And you don't do that by paying everybody in the market the highest number possible."

Faris said he doesn't believe the insurance companies when they say reimbursement parity would cause health insurance premiums to rise.

"They said if we pass tort reform, which I voted for, that insurance rates would go down and they haven't," he said. "I think they're taking this situation and using it as an opportunity to try and raise rates."

Discovery

On Jan. 29, 2007, Lynn Weaks sent Bowman a letter saying he was concerned about the reimbursement rates Arkansas Surgical Hospital was being paid.

 

 

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