MANAGED CARE: New Department To Regulate HMOs, Address Patients’ Concerns Opens Doors
Charged with protecting and educating 23.5 million Californians who are covered by 56 HMOs, the state's Department of Managed Health Care opened this weekend, the AP/Contra Costa Times reports. The department, touted as the first of its kind in the nation, will "regulate managed care plans, force HMOs to provide good care, resolve consumer complaints about treatment, protect consumers from the insolvency of health care and educate patients about their medical rights." Those duties were formerly assumed by the Department of Corporations, which was "widely criticized for being ineffective and unresponsive." The new department also will set up an independent review board for patients who feel their health plan "unfairly denied, delayed or changed treatment." A Financial Standards Solvency Board and an Office of the Patient Advocate round out the rest of the department. Department Director Daniel Zingale said that another of the department's concerns is to regain consumer confidence in managed care. He added, "I'm focused on the fact that Californians have lost faith in our managed health care system, and our primary concern is to restore faith in that system." The department maintains a $34 million annual budget (Wong, AP/Contra Costa Times, 7/1).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.