Carson Medical Group may drop HMO

Hundreds of people could be affected if a local medical group drops a Reno health insurance plan.

Carson Medical Group will stop carrying Saint Mary's HealthFirst, a Saint Mary's Health Network health maintenance organization (HMO) plan, on April 30 if it does not negotiate a contract with the network.

The network also provides other health care plans and runs Saint Mary's Regional Medical Center in Reno.

A sign at the Carson Medical Group's main office, 1200 Mountain St., says the group will no longer be a provider of the HealthFirst plan as of April 30.

Customers that use their plans and have the option of going to Carson Medical Group include employees of Carson City School District and Chromalloy Nevada, according to Don Kowitz, president of Saint Mary's Health Plans.

He said the network is negotiating with the medical group and, in a letter to customers, said "we fully expect that we will reach an agreement with Carson Medical Group to extend it well beyond that date."

Up to 3,000 people have a Saint Mary's health plan with the option of going to Carson Medical Group, but not all of them necessarily choose the group, Kowitz said.

A Saint Mary's representative didn't immediately have a number of people specifically with the HealthFirst plan.

Carson Medical Group likes to support local organizations, but a contract "has to make sense for us," said Michael Lillich, Carson Medical Group administrator.

He said the group will continue to negotiate with Saint Mary's.

Negotiations between medical groups and health insurance networks are common, Kowitz said, but he wanted to stress that St. Mary's contract with the group does run through April 30.

"We assure you that we will do our best to reach an agreement with Carson Medical Group that will be fair to both the physicians, our members and our customers," Kowitz said in a letter dated Jan. 16 that he will send to customers.

The group provided the Saint Mary's health plans through Physicians Managed Care until it pulled out in December 2007.

Saint Mary's is part of the nonprofit corporation Catholic Healthcare West and has worked with the medical group for about 15 years, Kowitz said.

Carson Medical Group is based in Carson City and also has an office in Minden. It has doctors that provide family, pediatrician, OB/GYN and other services.

• Contact reporter Dave Frank at dfrank@nevadaappeal.com or 881-1212.