Date: Fri 16-Jan-1998

Publication: Bee

Author: CURT

Quick Words:

health-Oxford-Health-audit

Full Text:

STATE TO AUDIT OXFORD HEALTH AT REQUEST OF LOCAL MEDICAL ASSOCIATION

NORWALK (AP) - The state Department of Insurance will audit Oxford Health

Plans, Inc, after a request from a local medical association that expressed

concerns over the HMO's financial problems.

Oxford will be audited in the first quarter, in either February or March, said

Sue Cogswell, an insurance department spokeswoman.

The Fairfield County Medical Association said its members were especially

concerned about nonpayment issues.

Members were asking why they kept hearing about insurance regulators in New

York who were investigating the company, but nothing about Connecticut, said

Laura Phillips, spokeswoman for the association.

In December, New York insurance regulators fined Oxford $3 million, citing the

HMO's inability to pay claims on time and other irregularities. Oxford agreed

to pay an estimated $500,000 in restitution to customers and health care

providers.

The fine came two months after the company reported a $78 million

third-quarter loss, causing its stock to nosedive. Oxford has said its

computerized billing system was partly to blame.

On Thursday, Oxford announced it was demoting Chief Executive Officer William

Sullivan and searching for someone better qualified to manage the HMO.

Cogswell said the insurance department has been monitoring the company since

its third-quarter loss.

Nicole Reilly, an Oxford spokeswoman, said Friday the company knows it is

being monitored but was unaware about the medical association's letter

requesting an audit.