ERIC PAUL ZAMORA/THE FRESNO BEE
The Rev. Sharon Stanley, center, helps carry a banner into the packed Fresno County Board of Supervisors' room during a board meeting Tuesday morning. Dozens of Hmong parents addressed the hardships they've faced since the contract between Children's Hospital Central California and Anthem Blue Cross ended Aug. 1.
Caught between hospital, insurer
Fresno County supervisors agree to help resolve contract dispute between Children's Hospital and Blue Cross.
By Barbara Anderson / The Fresno Bee
05/06/08 23:42:00

Quick Job Search

Fresno County supervisors agreed Tuesday to try to help resolve a 9-month-old contract dispute between Children's Hospital Central California and Anthem Blue Cross.

Dozens of Hmong parents filled the supervisors' chambers saying that since the contract was terminated, their children have to go out of town to receive care or wait months for approval to see a specialist.

The contract between Children's and Blue Cross ended Aug. 1 when the two sides failed to reach an agreement over payments for children enrolled in Medi-Cal and Healthy Families, two government insurance programs. Children's officials have said the hospital lost $11 million in 2006 on the Blue Cross contract.

Some parents have been told they must take their children to San Francisco for treatment, said Gia Xiong of the Center for New Americans.

"The reality is, a newly arrived refugee has no idea where San Francisco is or where the hospital is," Xiong said.

Supervisors largely faulted Blue Cross for what they said was a loss of access to health care for children.

"Blue Cross is saving money by not serving the Valley's children, and it's wrong," said Supervisor Susan Anderson.

Supervisor Bob Waterston said: "All it's about is money. It's not about children."

The supervisors ordered Dr. Edward Moreno, the county's health director, to come back with steps the county can take to ensure children have access to care. They also called for a legislative hearing to discuss health-care issues, including the contract dispute.

But it's unclear what role the county can play in resolving the conflict.

The county is not privy to confidential negotiations between an insurer and a hospital, said Julie Hornback, director of the county's Employment and Temporary Assistance department. The department is responsible for determining eligibility for Medi-Cal.

The state has a Medi-Cal contract with Blue Cross.

It's the state's responsibility to make sure health plans offer adequate access to care for children in the county, said Stan Rosenstein, chief deputy director of the Department of Health Care Services.

Rosenstein said county officials contacted him about the contract dispute. And he's had discussions with the hospital and Blue Cross.

"I was just down talking to the hospital in Fresno last week about a number of issues, including this one," he said.

"We can't force a resolution of one party or another," Rosenstein said. "But we are certainly urging both parties to be at the table to resolve it."

Children's is confident negotiations are progressing, said Tim Curley, director of community and government relations.

"I do know we're closer today than we have been since the contract expired," he said.

Blue Cross spokeswoman Leslie Porras described negotiations as "very positive" and said the company is "hopeful that we can reach an agreement here soon."

The reporter can be reached at banderson@fresnobee.com or(559) 441-6310.