Bela Biro: Molina Responds to OIC Determination

Bela BiroMolina Healthcare has been approved to be on the Exchanges in eight (8) of nine (9) states; Washington was the exception.   There are three areas Commissioner Kreidler noted as deficiencies in our filing:

#1.  Not enough “HIV/AIDS Doctors”—HIV/AIDS is not a recognized separate specialty according to the American Board of Medical Specialties.  However, we have 65 board certified Infectious Disease specialists and several hundred internists in Washington that treat the population with HIV and AIDS.

#2.  Not enough “proctologists”—Although the American Board of Colon and Rectal Surgeons no longer uses the term “proctologist,” our provider network does include 13 of the 25 board-certified Colorectal Surgeons in Washington, including all three who are based in Spokane.

#3.  No pharmacy network in place—our pharmacy network, through CVS/Caremark, has dispensed 2 million prescriptions in WA, in just the first six months of 2013.  There was a technical issue with regard to the contract, and that complete contract has been filed.

After weeks of the Office of the Insurance Commissioner’s (OIC) refusal to accept our electronic filings, we hand-delivered the pharmacy network on Tuesday (August 27) in a final attempt to get important information before the OIC for review.  Extending the federal deadline for Qualified Health Plans (QHP) data to allow more time for QHPs to be certified provides an opportunity for Washington to continue working on providing its citizens not only more options in the Exchange, but a choice of plans with experience in serving the needs of low-income populations.  We are ready to serve Exchange members in 2014 and look forward to further discussions with the OIC to make this a reality.

If you have any questions regarding these comments, please contact Laura Hart, laura.hart@molinahealthcare.com, Molina Marketing and Communications.

Bela Biro is the President of Molina Healthcare of Washington.