PacifiCare May Have to Open Some Health Files : Lawsuit: State is seeking records from Cypress company over service complaints.
An Orange County Superior Court judge indicated Wednesday that he is inclined to grant the state partial access to internal records of a Cypress health-care company to determine whether the company needs more supervision.
The Department of Corporations, which regulates health-maintenance organizations, demanded access to records of PacifiCare Health Systems Inc., saying the state had received numerous complaints from enrollees about the health care they were receiving through the company.
But Judge John M. Watson also indicated Wednesday that the state may be seeking too much information from PacifiCare about the company’s California health plan. He cited company estimates that complying with the demand would consume more than 49,000 hours of labor and cost more than $750,000.
He suggested that attorneys for the state and the company meet this morning to try to work out a compromise on examining files relevant to the specific complaints that the state has received. Attorneys are scheduled to return to court this morning to report the results of their deliberations.
In suggesting the state narrow its list of demands, Watson said, “The narrower that list, the more I’ll make PacifiCare do.”
The dispute arose in July last summer when the Department of Corporations demanded to inspect a sweeping array of company records dating back to Jan. 1, 1993.
The company refused and produced only a limited number of files, the state contends. In August, the company sued the state to block the state from pressing its demand.
The state countersued, seeking to force the company to provide access.
PacifiCare has been asked for access to members’ medical records, documents involving peer review of health-care decisions, and many other items.
During Wednesday’s hearing, the judge also appointed Phil S. Cifarelli, a UC Irvine professor with degrees in medicine and law, as an expert to assist him in wading through the evidence.
