Most Family Health Care Patients Still in Dark

Several thousand patients who were left without doctors after the collapse of a local medical group got good news Wednesday, when another physicians group said it would hire four Camarillo doctors who lost their jobs as a result of the company’s failure.

Patients of the four physicians can remain with them under their existing insurance plans.

But it remained unclear whether the majority of 135,000 patients covered by Simi Valley-based Family Health Care will be reassigned to other doctors or be forced to switch insurance plans if they want to continue seeing their longtime physicians.

In an attempt to ease patients’ fears, Family Health Care officials called a news conference Wednesday in the wake of this week’s collapse of the largest medical group in Ventura County. The group, with an estimated $6 million in debt, is expected to file for Chapter 7 bankruptcy today.

Family Health Care officials said that all 2,000 affected high-risk patients can continue to receive care from their doctors. They noted that one obstetrician delivered a patient’s baby through caesarean section Wednesday morning despite the fact that he may never be reimbursed.

They advised any patients who need prescriptions refilled to call their pharmacies, saying area pharmacies are in contact with the staff doctors who lost their jobs.

But that message wasn’t reaching some patients fast enough.

Just outside the news conference, 75-year-old Charles Wilkerson stood in front of a closed doctor’s office with his wife, Jessie, trying to find someone to check the 72-year-old woman’s cough and refill her prescription. The couple hadn’t been able to get answers over the phone.

As doctors left the news conference, Wilkerson confronted them: “I’m here to find out what . . . is going on. I’m concerned about my wife. She’s coughing real bad.” Doctors ushered the couple downstairs to an office so another physician could check on the woman.

Al Siegel, who owns Tapo Pharmacy, said state law allows pharmacists to give patients a temporary supply of medication in emergency situations. But Siegel, whose business is in the same building that Family Health Care Group had doctors’ offices, said business was slow Wednesday.

“We’ll probably know more in the next week or so” about how the bankruptcy will affect business, Siegel said. “It’s like [an] earthquake. You make do until everything’s up and running. We’ll get through this.”

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At least 23 of the 45 staff doctors who lost their jobs plan to organize into four separate clinics in Simi Valley, Family Health Care Medical Director Dr. George Dichter said. The clinics, which could open as soon as Monday, would focus on obstetrics, pediatrics, internal medicine and family practice.

“We expect by the beginning of next week we will be open again and seeing the patients we always have,” he said. Those doctors were responsible for the care of as many as 35,000 patients.

However, the new clinics want to be paid by insurers on a fee-for-service basis, not a capped rate as had been the case with financially overburdened Family Health Care.

Dichter acknowledged that Blue Cross, Health Net and other insurance providers affiliated with Family Health Care had not immediately agreed to restructure their payment plans simply to keep patients and doctors together.

It also was unclear what would happen to the remaining 85,000 Family Health Care patients who saw 850 area primary-care and specialty physicians affiliated with the group on a contract basis.

The state Department of Managed Health Care, which has come under fire from local doctors for failing to create a smoother transition, was urging insurers Wednesday to do whatever it takes to keep patients seeing their regular doctors, at least in the short term, which the state defines as 90 days.

“We are encouraging them to negotiate--at a minimum in the short term--for continuity of care,” said Joy Higa, assistant director for plan and provider relations with the state agency.

Meanwhile, Family Health Care officials said the state and various insurers should share the blame for the collapse of the group. The sudden collapse of the long-troubled organization came after a handful of insurers canceled contracts on short notice or failed to make expected payments, meaning there was no money to pay employees, Dichter said.

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But one area physician, who canceled his contract with the company after it failed to pay him tens of thousands of dollars, said the blame lies squarely on Family Health Care’s management.

“They’ve been playing a shell game with claims for months,” said Alan Mintz, a general and vascular surgeon based in Thousand Oaks. “These guys knew they were going under. These people have been grossly irresponsible. They could have made other plans for their patients.”

Many of the approximately 6,000 patients who saw Drs. Albert Reeves, Tara Yawata, Kevin Nishimori and Marcel Goldberg in Camarillo will be able to continue seeing them in their new affiliation with Buenaventura Medical Group, said that organization’s medical director, Dr. John Keats. The doctors are expected to start work there next week, Keats said.

About 200 of the Simi Unified School District’s 2,400 employees were members of the failed group, but school officials were satisfied that the health insurance companies were moving quickly to cover those members without doctors.

“Health Net has been very cooperative and very good to work with so far,” said Cary Dritz, assistant superintendent of personnel services for the school district. Insurance company representatives were sending regular updates to school officials, Dritz said.

Hundreds of Ventura County employees also depended on the health group for medical care, but they can take advantage of the county’s public medical services system if there is an emergency, Chief Administrative Officer Harry Hufford said. “We can say with confidence that if someone has a serious medical problem we can help them.”

Insurance plans using Family Health Care had already notified some patients about the group’s demise. Maxicare told patients in a letter that arrived Wednesday that enrollees could use the letter as temporary ID for services until they are assigned a new doctor in the next few days.

“Please be assured that this provider change has no effect on your current benefits or co-payments,” said the letter from Terry Kalamaras, vice president of service and operations. “Your Maxicare coverage and benefits will remain exactly the same.”

Talev is a Times staff writer and Anderson is a correspondent. Times staff writer Daryl Kelley also contributed to this report.