DMHC to Require Managed Care Organizations to Meet Preventive Health Standards
The Department of Managed Health Care yesterday announced plans to require managed care organizations to meet four preventive health standards in an effort to "save lives and dollars," the Contra Costa Times reports (Silber, Contra Costa Times, 6/20). Under new rules proposed yesterday, managed care organizations would have to submit prevention plans to the state outlining programs for smoking cessation, chlamydia screening, colorectal cancer screening and childhood immunizations. The insurers also would have to submit a follow-up report after one year (Ostrov/Sevrens Lyons, San Jose Mercury News, 6/20). The DMHC decided to focus on these areas because "they need the most improvement and would cost the least to implement," according to the department (Colliver, San Francisco Chronicle, 6/20). DMHC Director Daniel Zingale said, "We're reminding (the HMOs) that preventive health is considered basic health care under the law. From this point forward, the failure to make preventive health available to patients is a violation of patients' rights" (Contra Costa Times, 6/20). Zingale added that HMO members "don't just have a right to health care when [they]'re sick, [they] have a right to stay healthy in the first place."
Although many HMOs already have screening programs in place, the availability of some tests is "spotty," according to the department. For example, only 30% of HMOs cover smoking cessation programs, and there are "wide disparities" in childhood vaccination programs (San Jose Mercury News, 6/20). Managed care organizations said yesterday that they generally support the department's recommendations because the rules allow "freedom to come up with their own plans" and "put all the health plans on the same page in terms of prioritizing preventive measures." The proposed regulations will undergo a public review process, which could take several months (Contra Costa Times, 6/20).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.