DMHC Launches Web Site Allowing Patients Access to Outcomes of Challenges to HMO Coverage Decisions
The Department of Managed Health Care last week launched an online database of outcomes from the state's independent medical review process, giving patients access to the results of challenged HMO treatment decisions, the San Francisco Chronicle reports. Although the database does not provide the names of the health plans or patients involved in the cases, department officials say the information may help patients determine whether they have grounds for review of their own cases. The database, accessible through the department's Web site, allows consumers to search for cases by diagnosis or treatment and to access summaries of the medical review board's decisions. To date, the review board has overturned HMOs' denials of care in 211 of the 650 cases it has handled. The review process took effect last year as part of the managed care reforms passed by state legislators in 1999 (Colliver, San Francisco Chronicle, 1/5).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.