Speaker calls for conditions if HMO merger is approved | NevadaAppeal.com

Speaker calls for conditions if HMO merger is approved

Appeal Capitol Bureau

Assembly Speaker Barbara Buckley, D-Las Vegas, has sent the governor and insurance commissioner a letter urging them to impose protections for consumers if the proposed merger between Sierra Health Services and UnitedHealth Group is approved.

A total of four hearings have been held on that proposed merger. It was Gov. Jim Gibbons who called for added hearings after opposition arose to the $2 billion merger at the first meeting.

Opponents said it would give the new company a practical monopoly over HMO services in the state – 90 percent in Las Vegas and 80 percent statewide. They argued that would expose patients to possible abuse over the care they qualify for and give the company leverage to force medical providers to accept whatever discounts UnitedHealth demanded.

“These concerns prompt consideration of mechanisms to ensure problems do not arise for Nevada consumers and providers in the event the acquisition is sanctioned,” she wrote in the letter to Gibbons and Insurance Commissioner Alice Molasky-Arman.

Buckley wrote the letter after Gibbons predicted the merger would win approval.

“Obviously, there are various problems that have arisen with this merger and the creation of a monopoly,” she said Thursday. “The governor seemed to indicate (in a TV interview after the Las Vegas hearing) this would be approved, but if it is, we need to put in safeguards like those that have been done in virtually every other state.”

She said first that no merger costs should be passed on to consumers either directly through premiums or indirectly. She said a group of stakeholders, including the attorney general, should be established to monitor what’s going on, giving medical providers, patients and others in the health care system the ability to bring issues to the table.

She said the overseers should look at whether the company should be required to divest itself from certain markets or functions to prevent a monopoly “and a situation that would ultimately lead to higher prices, lower reimbursements to doctors and a decline in the quality of care.”

Finally, she said the company should make contributions similar to those in other states to remedy deficiencies in Nevada’s health care system.

“Just about every other state that examined this considered all these measures,” she said.

• Contact reporter Geoff Dornan at gdornan@nevadaappeal.com or 687-8750.