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Firm advertises discount plan

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By Lee Einer

Rita Torres of Health Care Partners says her uninsured program isn’t a medical discount plan. As she describes it, it definitely isn’t like most. Medical discount plans — also known as health discount plans — are programs that offer their members a discount on certain medical services. They typically do so by buying into preferred provider organizations networks established by conventional insurance companies. Thus, the member gets the same discount on their claims that a participating insurance company would get. But medical discount plans are not insurance. Medical discount plans pay no medical bills. They simply give you a discount if you go to a medical provider that participates in the plan. Medical discount plans, in most states (including New Mexico), are unregulated. In recent years, there has been a proliferation of such plans; many have used confusing language in their marketing, misleading unsuspecting consumers into thinking that they are buying cheap medical insurance, when there is no insurance involved, some agencies have warned. Some were undercapitalized and simply folded, leaving consumers holding the bag. As a result, many state insurance commissions have published consumer warnings about such plans; the Federal Trade Commission and the Better Business Bureau have also published alerts warning consumers about medical discount plans. But the for-profit Health Care Partners operates on a different model, Torres said. First, it does not buy into an existing PPO, but rather contracts with providers in the community to accept Medicaid rates as payment in full. Second, Health Care Partners provides a 24-hour nurse hotline and coordination of care. “What we saw,” Torres said, “is a need to team up providers with the patients. The key piece is the advocacy piece.” Torres said her group tells providers “if you accept the Medicaid rate without the Medicaid headaches, we will coordinate everything on your behalf. We are the alternative to managed care because we make it easier for the provider and affordable for the patient. We will decrease your overhead, assist you in arranging appointments and collection of payments.”Currently, Torres said, Health Care Partners is still in the process of training providers. It has signed up roughly 130 providers so far, primarily those with La Vida, Mesa and Statcare clinics in Las Vegas. It currently does not have a contracted local hospital. “We don’t make any profit on this program,” Torres said. “This isn’t our major line of business. This is a community service we are offering. “