HMO REGULATION: State Official Proposes New Plan
The state Department of Corporations is "beefing up" its efforts to regulate HMOs, the Wall Street Journal California edition reports. Dale Bonner, commissioner of the department, presented an initiative last week outlining a "multipronged" effort to increase enforcement efforts and respond to consumer complaints. Bonner said he is adding more operators to answer the department's toll-free complaint line, "nearly doubling ... the number of attorneys who handle these complaints" and giving his department until the end of the year to cut the "backlog" of complaints in half. The Journal reports that Bonner also "is creating a stand-alone enforcement division to specialize in health plan investigations." Under the new proposal, "all health plan audits and surveys will be immediately routed" to the department's enforcement branch, "so that it can determine whether it needs to take action."
Previously the DOC's "main focus" was encouraging health plans to correct their violations. "That takes too long and the plan may ultimately comply, but the law may have been violated for some time," Bonner said. While state officials are looking at other ways to regulate health plans, such as creating an entirely new department separate from the DOC, Bonner said his changes "are simply good government and 'not in any way an effort to quell'" other attempts at improvement. "It's a retrofit," he said.
Maureen O'Haren, a lobbyist for the California Association of Health Plans, "applauded" Bonner's initiative. "We strongly favor a strong regulator because without strong regulation and consistent forceful regulation, you have no public trust in the health plans and health-delivery system." But other consumer groups were not so pleased. Betsy Imholz of Consumers Union said the effort was "a step in the right direction," but that "it needs some real specifics that are lacking." Going even further with his criticism is state Sen. Herschel Rosenthal (D-Los Angeles), who said Bonner's "tune-up" is "too late." He said, "Where have they been? I'm not sure that the Department of Corporations is the place where anybody's concerned about health care. (Californians) are still very unhappy with their HMOs." Rosenthal and state Assemblyman Martin Gallegos (D-El Monte) are "spearheading an effort" to create "a new Board of Managed Health Care within the State and Consumer Services Agency." The panel would contain three gubernatorial appointees and two Legislature-appointed members (Benson, 7/15).
Medical Board Weighs In
The Medical Board of California in May adopted a proposal to remove HMO oversight from the DOC's jurisdiction and give authority to a newly created Health Care Service Plan Board. Members of the HMO regulating board would be jointly appointed by the governor and state Legislature, with the board chair being a gubernatorial appointee. The board would be required to seat a majority of consumers (Medical Board of California Action Report, July 1998).