LEGISLATURE: The Week that Was on the HMO Debate
Adding fuel to the HMO reform fire, a new report by the Department of Corporations finds that only a "scant few" of California's 23.5 million residents enrolled in managed care plans ever "formally complain about treatment." While HMO lobbyists assert that "problems may not be anywhere near as great as the daily press reports," consumer advocates suspect a different factor at work, namely that patients don't know who to call. All complaints must go through the Department of Corporations -- which the AP/San Francisco Examiner calls an "obscure agency" (Howard, 8/30). Meanwhile, the California Association of Health Plans is "crying foul" over proposed legislation that would allow patients to consult outside review boards in cases of denial of care and require HMOs to cover whatever treatment the board found appropriate. HMOs say they don't have a problem with either provision, but should a board recommend denial of care and an HMO comply, the bill does not allow the HMO to present that advice in court if a patient should sue (Bole, San Francisco Business Times, 8/30 issue).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.