The receivership partner administering WINhealth for the Wyoming State Insurance Commissioner Tom Glause told the WMS this week that progress towards bringing WINhealth towards liquidation is going smoothly.
The State Insurance Commissioner was granted a court order to place WINHealth into receivership on Oct. 21 and has been effectively running WINhealth ever since with its receivership partner, Regulatory Services Group. Joe Holloway is now at the helm of WINhealth and said the process for winding own WINhealth is progressing.
“We have paid $6 million in claims to providers since October 21,” Holloway told Wyoming Medical Society on Friday.
Among the bigger concerns with winding down WINhealth has been the fact that once WINhealth goes into liquidation, all health insurance policies it has carried will be voice within 30 days, meaning those who had coverage through WINhealth will be without. The State Insurance Department has been using its contacts to try to find comparable coverage from outside insurance carriers since WINhealth went into receivership. Holloway said that process has been successful.
“We have made good progress in finding new carriers for our members,” he said. “Blue Cross, for example, has quoted 120 of our 150 groups. We anticipate having no members in 2016 and having the company placed into liquidation in early January so that the Guaranty Fund can be triggered and pay the remaining claims.”
The Wyoming Life and Health Guaranty is a sort of non-profit reinsurance program that is available to pay WINhealth debts. Glause said there might be as much as $33 million available to pay claims and other WINhealth debts, however that cash is largely unavailable until the liquidation process kicks in.
Holloway added that his organization has also seen some of the employees of WINhealth find work elsewhere, pointing out the organization is 16 employees down, though the cross-training of other employees has allowed WINhealth to continue its work.
Several WMS members have sought clarification from WMS regarding the continued validity of their WINhealth provider agreements and questioning whether those agreements remain in effect with WINhealth’s receivership. Last week, the attorney general’s office offered its opinion, saying it believed the agreements are still in effect.
“Our position is that the agreements remain valid and in-force,” wrote Jonathan Coppom of the Attorney General’s office. “As a result, we advise providers to continue as they did prior to the commencement of the WINhealth rehabilitation–continue to see patients, existing and new, under the contract, and bill under the contract just like they did in the past.”
Healey, has asked the Attorney General to provide the reasoning for its position, which appears to run counter to the agreement’s language it is simply void if WINhealth fails to conform to Wyoming’s HMO statutes. Healey expressed concern that WinHealth’s provider agreements appear to be simply void, since the Insurance Commissioner’s receivership Petition states (twice) that WINhealth failed to maintain the “surplus,” required under Wyoming law (starting in the summer of 2015). As of the time of this release, the Attorney General’s office has not provided further comment.
Healey said that, while he recommends WMS‘ members consult their own legal counsel regarding their obligations under the WINhealth provider agreement, WMS’ significant concerns on the validity of the provider agreements remain, notwithstanding the AG’s stated position. While there appears to be little risk in treating the provider agreements as intact at this point, Wyoming physicians could end up on the short end of the stick if WINhealth runs out of money to fund all reimbursement claims.