Consumer Groups Petition Managed Care Department to Allow Access to Arbitration Records
Through a petition filed Tuesday, two consumer organizations are asking the state's Department of Managed Health Care to require health plans to disclose all documents and information obtained during arbitration processes to resolve care disputes, the Sacramento Bee reports. The Foundation for Taxpayer and Consumer Rights and the Health Administration Responsibility Project are sponsoring the petition, which gives department Director Daniel Zingale 30 days to decide if he will expand current public record regulations. According to the petition, opening the records would "give patients an edge" when negotiating with health plans for denial of treatment coverage. A recent report from the California Research Bureau found that many health plans are "failing to report arbitration results," which is required by law. Jamie Court, executive director of the Foundation for Taxpayer and Consumer Rights, said making arbitration records public "would give the public and the state a tool to judge the seriousness of allegations against HMOs and determine how credible the arbitration process was." The California Association of Health Plans, however, said that public disclosure raises "serious privacy and liability issues," which the association maintains would make settlements "more difficult to achieve." In addition, some health care experts say that "patients already unsure of their right to challenge HMO decisions may not be able to decipher records once they have them," the Bee reports. Before he makes a decision on the matter, Zingale said he will complete "a lot" of research. He added, "What we're most interested in right now is finding out how health plans are using results of arbitration to improve care for all patients. We don't have information on that" (Rapaport, Sacramento Bee, 2/14).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.