Association to Stop Hearing Health Care Disputes Involving Mandatory Arbitration
In a move that will "put pressure on California doctors, hospitals and health plans to stop forcing patients into arbitration," the nation's largest provider of dispute resolution will tell California lawmakers tomorrow that patients "should have the right to forgo arbitration in health care disputes and file lawsuits directly in court," the Los Angeles Times reports. The American Arbitration Association will no longer permit its arbitrators to handle health care cases "unless both sides voluntarily agree to the out-of-court process," senior vice president Robert Meade said. Contending that arbitration is "speedier, less contentious and not subject to the variability of juries," the "vast majority" of California managed care plans require enrollees to sign mandatory arbitration clauses -- which many states prohibit -- as a condition of enrollment, the Times reports. Such clauses, which often are also required as a condition of seeking care with many providers, are unfair with regard to health care, Meade said. He will outline the association's new policy before the Assembly Judiciary Committee tomorrow. "Nothing is more emotional or personal or devastating than a health care problem. If you buy a lemon car, it's not life or death. It's not a medical problem. That's what puts this on a higher playing field," he said. In 1997, the arbitration association -- which last year handled 16 health care cases out of more than 200,000 disputes -- formed a task force with the American Bar Association and the American Medical Association to study health care arbitration. The panel concluded in 1998 that arbitration should only be an option if a patient voluntarily agrees after a dispute occurs -- a recommendation that the arbitration association is now implementing. "This is going to make waves," Meade said.
Some consumer advocates and lawmakers praised the policy shift, saying it will make the arbitration process more fair for consumers. "This is really a very big political trump card to move the issue forward after years of being rebuffed by HMO lobbyists," Jamie Court, director of the Foundation for Taxpayer and Consumer Rights, said, adding, "This is proof positive that it's unethical medically and legally to force patients into a secret process that's stacked against them." Earlier this year, Department of Managed Health Care Director Daniel Zingale said the current arbitration system "probably favors HMOs over patients" and asked insurers to provide data on arbitration verdicts to determine whether changes are needed. However, officials at Kaiser Permanente, the state's largest managed care plan, said the criticism of the mandatory arbitration system is "misplaced." With a voluntary system, consumers could choose a venue most likely to award them the most money, Michael Hawkins, Kaiser's legislative representative and senior counsel, said, adding, "Reasonable people disagree about the issue of voluntariness. A mandatory system is the only system that we believe that we can manage" (Ornstein, Los Angeles Times, 3/11).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.