County steps aside in health care deal

With some misgivings, the Clark County Commission cleared the way Tuesday for UnitedHealth Group to buy Sierra Health Services for $2.6 billion.

UnitedHealth, the largest U.S. health insurer, sweetened the deal by offering to toss a hefty sum at financially strapped University Medical Center.

The health-care giant will donate $7.13 million to the hospital and immediately pay half of the $2.2 million in billing that it owes the hospital. In return, the hospital waived its right to challenge the merger.

A few commissioners expressed lingering qualms about UnitedHealth dominating the market, but most thought accepting the buyout was better than fighting it in court.

"We're getting the best that we can with this particular agreement," Commissioner Chip Maxfield said.

Commissioner Chris Giunchigliani, who cast the lone "no" vote, worried that UnitedHealth could become too powerful and jack up its insurance rates.

"I still think it's a monopoly," Giunchigliani said. "I'm not going to support this."

The buyout would put about 780,000 Nevada customers under UnitedHealth's umbrella. That is more than triple the size of the state's second-largest health insurer.

The Justice Department signed off on the merger last week and said UnitedHealth met antitrust standards when it passed 27,000 Medicare Advantage clients in Clark and Nye counties to Humana, a Kentucky-based company.

Unions and doctors' associations oppose the buyout. But neither union representatives nor doctors spoke at Tuesday's meeting.

California regulators have accused UnitedHealth of mishandling claims and causing excessive delays in payments after it took over PacifiCare. In January, the company faced fines of $1.3 billion.

And last year, UnitedHealth agreed to pay a total of $20 million in 36 states to resolve problems with claims.

That reputation made county leaders uneasy, but UnitedHealth's good-faith gesture toward the hospital seems to have assuaged some fears, said Mary Miller, the county counsel.

Commissioner Tom Collins, who was absent during Tuesday's vote, said he probably would have expressed reservations about creating a monopoly and then backed the buyout.

"We're stuck," Collins said. "We don't want a protracted court battle that we might not win."