Buyout sessions conclude

A series of public-comment sessions regarding UnitedHealth Group's proposed purchase of Sierra Health Services ended Friday, with locals offering conflicting statements to Nevada regulators who must now decide whether to approve the deal.

Of the 47 people who commented on the $2.6 billion merger Friday at the Grant Sawyer State Office Building, 18 supported the deal and 24 opposed it. Five either said they needed more information or they had no opinion on the sale yet.

Among those supporting the deal were insurance and benefits consultants, nonprofit executives, doctors and patients.

Doctors and patients also lined up to decry the buyout, as did nurses and owners of small medical-services businesses. The Clark County Medical Society sent a representative to argue that the merger would be anti-competitive. The Service Employees International Union, which represents seven out of 10 nurses in Southern Nevada, had a strong presence at the meeting as well. The union is against the acquisition because members believe the deal would create a monopoly that would lead to lower reimbursement rates for providers and limit consumers' access to care.

Mike Rogers, an SEIU member who works in Clark County's Department of Real Property Management, told the commission that Minnesota-based UnitedHealth has "set industry records" for fines, receiving more than $5 million in levies from Nebraska, Arizona and Texas.

"UnitedHealth has a track record of poor business practices that could put our community in danger," Rogers said.

The levies, which were for violations including failing to keep proper records and not handling service-denial appeals quickly, indicate "the kinds of business practices that could devastate our community," he said.

Gwen Johnson, owner of a prosthetics company in Las Vegas, said UnitedHealth, the country's largest managed-care insurer, already has a national provider of prosthetics. She's worried the company's takeover of Sierra Health would result in her and other local prosthetics companies' being excluded from Sierra Health's provider list. Patients using her services would have to shell out 20 percent copays if that happened, and that would reduce patients' freedom of choice. It could also kill her company, she said.

Sierra Health customer and cancer patient Carol Austin-Fink also spoke against the merger.

Austin-Fink said she's been trying for 14 months to convince Sierra Health, the largest managed-care insurer in Nevada, to authorize the repair of jaw damage that resulted from chemotherapy.

"Sierra Health is denying care, even though their revenue increased 20.5 percent in the first quarter," she said. "They should be investigated for callous denial of care."

Allowing the deal to happen would reward the pursuit of profits over providing care, Austin-Fink said.

Jonathon Bunker, president and chief operating officer of Sierra Health, commented as a member of the public to "put a personal face to this transaction."

Bunker, who would become regional president of UnitedHealth's Southwest region if the deal closes, gave an impassioned statement supporting his colleagues.

"It pains me when I hear the characterization of these people (UnitedHealth and Sierra Health executives and workers) as something less than above-board," Bunker said. "There's no doubt Sierra Health's legacy would not only continue (after the merger), but would go another step in caring about people."

Bunker and Sierra Health had their advocates in the crowd.

Small-business owner and former gaming executive Robert Ostrovsky said he's bought services from Sierra Health numerous times, and has had positive experiences with the company.

The merger is a sign of the Nevada health-care market's increasing maturity, Ostrovsky said, and with that maturity will come lower costs, improved technology and national provider networks. It will also lure other big insurers looking to compete for business in Nevada.

"UnitedHealth will have to work hard to protect the Sierra asset," Ostrovsky said.

Patrick Leary, executive director of Catholic Charities of Southern Nevada, praised Sierra Health's involvement in local philanthropies. He said Sierra Health executives have assured him that UnitedHealth's buyout would only expand the help Sierra Health gives the state's needy.

"If anything, they would wrap their arms around us even more," Leary said.

Ken Burdick, president and chief executive officer of UnitedHealthcare, said during a break in the session that the testimony he heard in Reno and Las Vegas was balanced.

He also said he appreciated the feedback coming from the public meetings.

"We're genuinely interested in hearing what people's concerns are," Burdick said. "We're interested in being here for the long term, and we want to work with the community."

The fines Rogers mentioned resulted from the administrative hiccups of merging with other companies and absorbing their operating platforms, Burdick said. Such issues wouldn't happen after the Sierra Health purchase because the company's operations, including its Southwest Medical Associates clinics, would keep their processes and procedures postmerger.

Given the public's mixed testimony, Burdick said he doesn't "assume by any stretch" that the insurance commission will approve his company's acquisition of Sierra Health. But he said he was "optimistic" that the transaction would get the nod once regulators have studied the materials related to the sale.

Nevada Insurance Commissioner Alice Molasky- Arman plans to issue a decision on whether to approve the merger in 30 days, Deputy Insurance Commissioner Pamela Mackay said.

The federal Department of Justice and the Nevada attorney general's Bureau of Consumer Protection are also looking into the buyout's implications. Agencies in California and Texas must also OK the purchase.