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Doctor Questions List of Peers Signed Up for Medi-Cal Pilot Project

January 15, 1986|LYNN O'SHAUGHNESSY | Times Staff Writer

A San Fernando Valley physician Tuesday challenged a state list of local physicians who have agreed to continue seeing their Medi-Cal patients under a proposed pilot project that was supposed to begin this summer.

The physician, David Chernoff, president of the West Valley chapter of the Los Angeles County Medical Assn., said at a hearing on the project that he doubted the list was accurate, in part because his name was on it. He said he has not signed up for the pilot project, which would require him to become affiliated with a health maintenance organization.

Under the plan, called Expanded Choice, Medi-Cal patients would be required to receive medical treatment from HMOs in order to continue to receive state benefits.

'Grave Questions'

"There are grave questions about the veracity of the list," Chernoff concluded. The medical association, he added, randomly surveyed 28 of the hundreds of physicians on the list, and none of them knew they were on it.

The hearing is one of four being conducted this week at the State Office Building in Van Nuys, despite uncertainty about the future of Expanded Choice. The 1986-87 budget released last week by Gov. George Deukmejian did not include the money needed to start the experiment in the Valley this summer.

Administration officials said the governor wanted to delay the experiment until mid-1987 because of budgetary constraints and community opposition.

Michael W. Murray, executive director of the California Medical Assistance Commission, which is overseeing the experiment, said the hearings were not postponed because the program is not dead yet. The $23 million needed for the program might be found or a scaled-down experiment tried, he said.

Last month, the state announced that most Medi-Cal recipients would be able to continue seeing their own doctors under the pilot project because many area physicians had agreed to participate.

According to the commission, 71% of the 87,000 Medi-Cal recipients in the Valley-area experiment use physicians who had said they would participate in the project.

Jim Foley, director of the Valley experiment, stood by the commission's figure on Tuesday. He said physicians were not included in the count unless they had signed letters of intent with one of seven participating HMOs. There might be a few physicians who do not belong on the list, he said, but he promised any errors would be resolved before the program begins.

HMO officials have rarely spoken at the many hearings held on Expanded Choice since the program was unveiled last summer. This has left commission officials to defend the program against vocal and organized critics. But this time, Dr. Bruce Barnett, a Valley family practitioner affiliated with United Health Plan, stood up to confront the opponents.

The health care by the HMOs under Expanded Choice will be "superior to what they faced before," Barnett contended. He accused the medical organizations of opposing the concept for financial rather than ethical reasons.

"I'm worried that their greatest concern is the program will actually succeed," Barnett said.

Commission officials said they will continue to work with the HMOs to ensure that each will be able to provide complete health coverage. One weak area, commission officials conceded, is that the HMOs have signed up few pharmacies and nursing homes.

Glenn Bennett, president of the Valley chapter of California Assn. of Health Facilities, which represents nursing homes, said only one of the seven HMOs has contracted with nursing homes to provide care. Bennett urged the commission to exclude long-term care from the program because of the paucity of facilities.

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