California Regulators Work on Rules Taking Aim at HMO Wait Times
By the end of the year, the California Department of Managed Health Care hopes to release rules that will require HMOs to ensure that members have timely access to medical services, the Sacramento Bee reports.
The rules would stipulate the maximum amount of time an HMO member could wait for a physician, depending on the nature of the illness and the physician's specialty. California will be the first state in the nation to adopt such regulations.
A 2002 law directed the department to implement the rules by 2004, but scrutiny from physicians, health plans and consumer groups delayed the regulations' release.Â In addition, the Office of Administrative Law blocked draft regulations last year because it said the public hearings on the proposed rules violated state guidelines.
Consumer advocates are pushing for the regulations as soon as possible, but the California Association of Health Plans is requesting at least a year for HMOs to comply with the regulations before facing penalties.
In addition, the California Medical Association has questioned whether physicians will be able to accommodate the rules' requirements.Â
Armand Feliciano, CMA associate director of medical and regulatory policy, said, "You must first ensure that the HMOs have enough doctors in their networks" (Calvan, Sacramento Bee, 5/14).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.