HMO Changes Vaccination Stand
PacifiCare of California is taking steps to meet state regulators’ demand that it endorse vaccinations for chickenpox.
The health maintenance organization came under scrutiny last week by the state’s Department of Corporations, which regulates HMOs, for not recommending the widely accepted preventive measure. Though the company covers the vaccination as a health benefit, it recently drew fire from a consumer group not recommending it.
A spokesman for the HMO, a unit of PacifiCare Health Systems Inc., said Monday that it plans to issue a new policy today that reflects its new support for recommendations by the American Academy of Pediatrics, the American Academy of Family Physicians and the federal Centers for Disease Control. The company intends to send letters next week to inform medical and individual doctors who deliver care to its members.
The spokesman said, “What we are saying to doctors is, ‘Please engage in open discussions with your patients to inform them that we have accepted these sets of national guidelines.”
It’s unclear, however, whether PacifiCare’s about-face will satisfy regulators.
Jamie Court, director of Consumers for Quality Care, the Santa Monica consumer group that is critical of the HMO’s vaccination policy, said it is still not doing enough. “I would be disappointed if the state did anything less than require PacifiCare to take out full-page ads in newspapers and telegram their patients about the option of receiving the . . . vaccine,” Court said.
Damian Jones, a Department of Corporations spokesman, said late Monday that the department was waiting for the HMO to fax documents indicating its compliance with the law. On April 2, the department’s legal counsel, Warren Barnes, sent a letter to Jon Wampler, the HMO’s president, asking the company to respond “in triplicate” by Monday to newspaper accounts that it was discouraging the vaccinations.
Jones said it was too early to tell whether PacifiCare’s response is sufficient. Asked whether PacifiCare might have to take additional steps to alert consumers, he said, “We can’t rule anything in or out. I don’t know what legal counsel will decide.”
The first vaccine against the varicella virus, better known as chickenpox, was approved for marketing domestically last year. Drug giant Merck & Co. of Whitehouse Station, N.J., markets the only available vaccine, trademarked “Varivax.”
About 3.7 million Americans contract the generally mild disease each year. For some, though, chickenpox is a serious illness. About 9,300 patients are hospitalized each year with chickenpox, and 50 to 100 people, mostly small children, die.
The vaccine costs about $40 a dose.
Court also questioned whether PacifiCare misled the state last year into believing that it was complying with the law. He cited a portion of Barnes’ letter that says, “Based on the Department’s correspondence and conversations with PacifiCare regarding Varivax in mid-1995, we understood that the plan acknowledged that [state laws] require the provision [of] Varivax vaccinations for children pursuant to the recommendations of the American Academy of Pediatrics.”
The PacifiCare spokesman wouldn’t comment.
