Davis Pushes Legislature to Protect Patients from Losing Coverage During MCO-Provider Contract Disputes
In a letter sent to state legislative leaders yesterday, Gov. Gray Davis (D) "renewed" his push for legislation to ensure continuity of care for patients when their doctors and managed care organizations have contract disputes, the Los Angeles Times reports. Bills to ensure such coverage "stalled" in the last week of the legislative session in September. Davis said that passage of such legislation when the state Legislature reconvenes in January is "imperative" to protect as many as 800,000 residents from "disruptions in their health care," the Times reports. Under current law, only those patients in the final months of pregnancy or those who are being treated for "serious illnesses" such as cancer or AIDS may continue to see their doctor during contract disputes. Other patients are required to find new doctors. The Davis administration has proposed requiring physicians to continue treating patients for up to one year during a contract dispute. The Times reports that it has not yet been determined how doctors would be reimbursed for those services. One option would require insurers to reimburse doctors at the old rates plus the cost of medical inflation. The Times reports that Davis' plan has been criticized for favoring health plans. But Daniel Zingale, director of the Department of Managed Health Care, said some of the issues have been resolved, including the elimination of a proposal doctors thought would have require them to treat patients for up to a year without reimbursements to avoid jail time. Sen. Jackie Speier (D-Hillsborough) said, "We will (resolve it), but it is not a simple 'just do it'; it is complex. The key factor is the importance of maintaining the doctor-patient relationship" (Morain, Los Angeles Times, 11/28).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.