Department to Aid Managed-Care Plans; New Agency’s Director Sets Goals at Conference for Health Care Industry

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San Diego Union-Tribune

MISSION VALLEY, CA- Daniel Zingale, director-designee of the state’s newly created Department of Managed Care, told a statewide audience of health care
executives yesterday that he has two major proposals to unveil: Anti-baldness formula Rogaine should be covered because of medical necessity, said Zingale, who has a shaved head. Instead of hitting the health plans with a special $11 million assessment charge to help get his department started, Walter Zelman, president of the California Association of Health Plans, would instead be charged a nickel each time he gets mentioned in The Los Angeles Times.

Zingale was kidding, of course. And the exchange provided a light-hearted note to the gathering, which has been dominated by discussions of controversies plaguing the state’s health care industry.

Zingale’s appearance, as well as state Sen. Jackie Speier, D-San Francisco, at the Doubletree Hotel in Mission Valley capped the three-day annual conference of the state’s association of managed-care plans.

While Zingale offered little in the way of details, the speech reinforced earlier discussions he’s had with those in the health care industry. His department, set up to regulate health plans, isn’t so interested in punishing bad operators as it is in “preventive regulation” — ways to improve the quality of care and the delivery of it before enforcement of legislation is necessary.

“He doesn’t want to manage us to death. He doesn’t want to nitpick managed care organizations over $5 parking violations. He is saying I’ll carry a significant stick for major problems,” Zelman said.

Beau Carter, executive director of Integrated Healthcare Association,a statewide leadership group of health plans, health care systems and physician organizations said the Department of Managed Care “needs someone who has a good patient-advocate background who understands managing care patients with difficult problems and diseases . . . but he’s not somebody who comes in with a chip on his shoulder.”

By all accounts, Zingale faces tremendous pressure and expectations. He has his current position in part to the failure of the Department of Corporations, which will continue to oversee the state’s health plans until July 1 — or when Gov. Gray Davis signs an executive order creating the Department of Managed Care.

Because the Department of Corporations has been seen largely as ineffectual, expectations for Zingale and his department will be very high.

“He’s basically being dipped into a pot of boiling water and he doesn’t even see the water rising,” said Jamie Court, advocacy director for The Foundation for Taxpayer & Consumer Rights, a consumer advocacy group based in Santa Monica.

“He has an abominable, daunting task and he understands the new department will be under the microscope by all players in the industry,” said Assemblyman Martin Gallego Gallegos, D-El Monte,who sponsored the bill creating the department.

The Department of Managed Care doesn’t have a staff and is in the process of trying to hire 131 employees. Including the staff that will transition from the Department of Corporations, it will have approximately 300 employees.

While not commenting on policy issues, Zingale laid out some plans he has for the department. They include creating a Consumer Resources Center, part of a larger blueprint to make the department more consumer-friendly. The Department of Corporations was criticized as being a blight to consumers looking for information about and action against health plans.

He also plans to create a Plan-Prover Relations Office to allow health plans to offer ideas.

“The message I was trying to get across was that I have an open-door policy to solve problems on the front end — I want to work with them — but you also heard me say that if they don’t put patients first I will act swiftly and decisively,” Zingale said.

Consumer Watchdog
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