Davis Approves Physician ‘Bill of Rights’ To Regulate HMO Contracts with Doctors

Gov. Gray Davis (D) yesterday signed into law a bill (AB 2907) that establishes a physician "bill of rights" to "limit health plans' ability to unilaterally change contract terms" with doctors in the state, the San Diego Union-Tribune reports. Although current state law requires "fair and reasonable" contracts between HMOs and providers, the new legislation clarifies the requirements, according to Daniel Zingale, director of the Department of Managed Health Care (Fong, San Diego Union-Tribune, 9/27). Davis said that many HMOs in the state have forced providers to treat additional patients, revised contracts "without warning" and "been lax in payments to physicians" (Coleman, AP/Sacramento Bee, 9/26). Under the new law, sponsored by Assembly members Rebecca Cohn (D-Saratoga) and Helen Thomson (D-Davis):

HMOs cannot require doctors to accept more patients than can "reasonably be cared for";
HMOs must "fully disclose" revisions made in contracts with providers 15 days before implementation of new requirements;
HMOs cannot establish contracts that conflict with state regulations; and
HMOs cannot request access to patient information protected by federal or state laws (Office of the Governor release, 9/26).

Supporters predict that the law, which takes effect Jan. 1, will "stem the flow of doctors leaving the state," the Union-Tribune reports (San Diego Union-Tribune, 9/27). "Today we have the strongest patients' rights in the nation. ... But in order to provide patients with world-class care, we must ensure that our doctors' have world-class rights," Davis said (Office of the Governor release, 9/26). However, Walter Zelman, president of the California Association of Health Plans, said, "The organized physician community seems to think that HMOs are oblivious to (the) law, that there are no rules enforced, that we're routinely violating contracts that we've signed with physicians. You can't do these things, and we don't do them" (San Diego Union-Tribune, 9/27). 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.