North Texas legislators seek tougher action against health care contractor Evercare

10:41 PM CST on Wednesday, February 11, 2009


By ROBERT T. GARRETT / The Dallas Morning News

rtgarrett@dallasnews.com

AUSTIN – North Texas lawmakers have urged the state to crack down on a health insurer that manages care of the area's 78,000 elderly and disabled Medicaid patients.
Republican Sens. Jane Nelson of Flower Mound and Chris Harris of Arlington said Wednesday that fines against Evercare of Texas haven't worked.

At a Senate Finance Committee hearing, both senators said that they still field many complaints from Evercare plan members who can't find doctors willing to see them.

"Citizens are finding it extremely difficult to find a provider," Nelson said.

Nelson, the Senate's chief health policy writer, recounted taking a call from a woman with a uterine tumor. The woman couldn't obtain treatment because no local gynecologist would sign a contract with Evercare, a unit of the giant UnitedHealth Group, Nelson said.

"We just don't seem to be getting anywhere," Nelson told Albert Hawkins, who runs Medicaid in Texas as head of the Health and Human Services Commission. "We've got to do something to fix it."

The problems that Texans have had with Evercare were the focus of a Dallas Morning News investigation last month.

Hawkins said he shares lawmakers' frustrations, though he stopped short of threatening to revoke the UnitedHealth subsidiary's $1.8 million-per-month contract.

An Evercare spokeswoman said the company has made "significant progress" lately.

"There were challenges taking over this program from the state, but we continue to work aggressively to address each member's concern," said Beth Mandell, the company's regional executive director.