Oklahoma health care providers to receive $15.3 million in HMO insolvency case

The collapse nearly a decade ago of AmCare Health Plans left many Oklahoma hospitals and other providers “holding the bag,” insurance commissioner said.
BY DON MECOY dmecoy@opubco.com Published: August 11, 2012
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Checks totaling $15.3 million will be paid to Oklahoma health care providers this month to cover some of the losses in the 2002 failure of a health maintenance organization that had 38,000 state clients, the Oklahoma Insurance Department said Friday.

AmCare Health Plans was providing health care payments for 38,000 Oklahoma clients until it stopped operating Oct. 1, 2002. About 26,000 of those customers were state employees or their dependents.

The HMO never produced a profit in Oklahoma and fell behind in payments to providers after suffering a $12 million loss in 2001. At that point, many provider groups began refusing AmCare patients.

Insurance Commissioner John D. Doak said the first check, for $204,530, was presented Friday to Integris Baptist Health Center.

“This is great news for Oklahoma hospitals and medical providers,” Doak said.

“They were left holding the bag when this company failed to pay hundreds of claims. Now, finally, these claims will be paid in full.”

Shifting assets

Oklahoma, Texas and Louisiana filed suit against AmCare after it was placed in receivership in 2003. Investigators found AmCare was severely undercapitalized and was manipulating its financial records by moving assets back and forth between sister companies in an attempt to appear solvent.

“AmCare had no intention of paying its claims,” Doak said.

“This was a purely financial move on their part and we won't stand for it,” he said.

This month's checks, administered through the Oklahoma Receivership Office, will complete principal payments to the affected providers. In 2006, the Oklahoma Insurance Department successfully petitioned the court for an early distribution of about $8.8 million.



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