PacifiCare Says Its Changes Should Satisfy Texas Regulators

PacifiCare Health Systems Inc., which has been under examination since November by Texas regulators for late claims payments to physicians and other deficiencies, said Friday it now complies with those state regulations.

The Texas Department of Insurance notified the Santa Ana managed care company that it no longer is under “administrative oversight,” PacifiCare said.

Staffing in the PacifiCare unit that processes claims in Texas has been increased 85%, to 246 employees, since November, spokesman Dan Miller said.

The company said its late payments were caused by a policy change: from paying medical providers a fixed amount per patient, regardless of attention needed, to a system of paying for actual services rendered. California regulators fined PacifiCare $250,000 in March for delinquent payments to doctors and hospitals.