$17 Million Repaid by OFIS

Office of Financial and Insurance Services (OFIS) Commissioner Linda A. Watters—in her capacity as court-appointed Rehabilitator for The Wellness Plan—announced today that eligible medical providers of The Wellness Plan have been repaid what they are deemed to be owed.

Watters said, “I am proud to announce that medical providers owed money from The Wellness Plan have received what is due to them. My staff and I have been working hard to ensure continuity of care to plan members and to secure reimbursement for the provider community. Both of these priorities have now been accomplished. I appreciate the patience and support of the provider community throughout this rehabilitation process.”

According to the order issued by Circuit Court Judge William Collette, OFIS has paid off providers who filed timely claims with the rehabilitator. After adjudicating the claims received from hospitals, doctors, and other providers through procedures approved by the court, $17 million of pre-rehabilitation claims have been paid to the providers who were owed funds and $13 million has been cashed. The Wellness Plan paid 100% of the contracted amount owed to the providers.

OFIS has been responsible for the rehabilitation of the Wellness Plan since the order was issued in July of 2003. Continuity of care was ensured in June of 2004, when the rights to serve members of The Wellness Plan HMO were sold. Providing full reimbursement to creditors is the second major accomplishment in the rehabilitation of The Wellness Plan.

“Protecting consumers and creditors from troubled HMO’s has been a top priority of my tenure,” said Watters. “The Wellness Plan has been a good example of the successful efforts the state regulator can take to protect the public from HMO’s gone bad. We have been able to save the clinics in Detroit which are a tremendous resource and provide the necessary care that many Detroiters need, and at the same time provide repayment to creditors.” said Watters.

Detroit citizens have also been able to receive care through Medicare, Medicaid and commercial plans at the clinics that are former Wellness Plan facilities. These clinics continue to provide services to the many Detroit residents who struggle to receive the medical treatment that they need. In mid-October, Commissioner Watters announced that she had filed a letter of intent for Federally Qualified Health Center (FQHC) “look-alike” status for the network of clinics operated by The Wellness Plan (TWP).

For additional information about The Wellness Plan, please visit the OFIS web site at www.michigan.gov/ofis and click on Who We Regulate, The Wellness Plan, Rehabilitation Documents.

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