CALIFORNIA HMOS: COMPLAINTS ON THE RISE
A state report released yesterday based on data from aThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
state-run, toll-free hotline shows a small rise in consumer
complaints against HMOs in California last year, Los Angeles
Times reports. The California Department of Corporations, which
regulates the state's 113 HMOs, registered 2,321 complaints for
1996, up 18% from 1,964 in 1995. This translates to 1.1
complaints for every 10,000 enrollees, as there are 19 million
people enrolled in HMOs in the state.
TIP OF THE ICEBERG
More recent data show that complaints are doubling. The
state's hotline was in operation for all of 1996. However, "many
HMOs failed to notify members of the hotline, prompting
corporations Commissioner Keith Bishop to levy fines against 80
health plans totaling more than $700,000." According to state
officials, it was "lack of awareness" of the hotline that
"explains what is a modest rise in complaints." According to Joe
Parra, "the agency's newly appointed ombudsman," (see AHL 5/27)
the number of calls to the hotline "increased dramatically"
following the announcement of the fines -- roughly doubling in
January and February. However, Jeanne Finberg, senior attorney
for Consumers Union's West Coast office, said, "We still fear
that the number of complaints (to the Department of Corporations)
is not anywhere close to reality." She also said there is no
information available on the seriousness of the complaints
registered through the hotline. Kurt Davis, a spokesperson for
Foundation Health Systems, said the numbers show that "the
industry is doing a good job of serving its members" (Olmos,
6/20).