- 15 - addition, Health Plans, petitioner, and Group entered into provider agreements with Davis Hospital and Medical Center, located in Davis County, Utah, because there were no Health Services hospitals in the immediate area. During the 2-year period including 1997 and 1998, UMC accounted for approximately 50 percent of all inpatient hospital services provided to petitioner’s enrollees by independent Utah hospitals. During the 2-year period including 1997 and 1998, UMC accounted for approximately 42 percent of all outpatient hospital services provided to petitioner’s enrollees by independent Utah hospitals. Petitioner maintained a Core Wellness Program under which its enrollees were provided health care information and a variety of health care services at no additional charge. Petitioner’s Core Wellness Program included annual worksite health screenings, group health risk profiles, a 24-hour nurse hotline, ergonomics assessment and consulting, worksite health seminars, and a health newsletter. Petitioner did not offer its Core Wellness Program to the general public. B. IHC Senior Care Health Plan Between 1996 and 1998, petitioner offered a Medicare “risk” health plan known as IHC Senior Care (Senior Care plan). Under petitioner’s Senior Care plan, Medicare eligible enrollees agreed to obtain their Medicare Part A (hospital services) and MedicarePage: Previous 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Next
Last modified: May 25, 2011