Torrance Health IPA, a mainland insurance provider, recently said it has followed industry standards for paying facilities that don’t have a contract with them such as the Catalina Island Medical Center.
Medical Center CEO Jason Paret said this week that the hospital estimates that THIPA serves around 600 policy holders on Catalina.
Medical Center CEO Jason Paret recently wrote his December report: “We have just completed a study of one of the commercial insurance companies, THIPA, that has clients that utilize our ER,” Paret wrote. “Since January 15th, they have accumulated $680,292 in charges. Out of the $680,292, they have paid Catalina Island Medical Center $58,853 or at a rate of 8.7% of charges.”
Last week, the Catalina Islander requested a response from THIPA/Torrance Memorial Medical Center. THIPA sent the following on Friday, Dec. 21, after last week’s paper was published:
“Torrance Health IPA was contracted with Catalina Island Medical Center and operated under a mutually beneficial relationship for many years. In 2017, Catalina Island Medical Center gave notice to terminate the contract. Torrance Health IPA remains open to a good faith, fair and responsible contract. Regarding the report made by the Avalon Municipal Hospital Board of Trustees, Torrance Health IPA has followed industry standards for reimbursement to non-contracted facilities and has made appropriate payments based on usual and customary fees for services rendered since the termination of the contract,” said the THIPA statement.
Due to a reporting error, last week’s article incorrectly reported that the Medical Center and THIPA were negotiating a contract. “THIPA has not engaged CIMC in negotiations to provide CIMC with a fair and reasonable contract to pay for services provided to patients that are covered by their healthcare plan,” said Paret this week in an email to the Islander.
“It is a complex situation where THIPA is arbitrarily deciding what it will reimburse CIMC for when patients receive care in the emergency room,” Paret said.
Correction
Last week’s article, “Hospital to lease new CT machine,” (Catalina Islander, Dec. 21, 2018), misidentified the entity to which Catalina Island Medical Center CEO Jason Paret recommended accepting a lease agreement for a new CT scan machine.
The article should have said Paret made his recommendation to the Avalon Medical Development Corporation Board of Directors.
