PAYMENT DELAYS: MDs Enlist Patients to Scuffle with HMOs
Arming themselves with a "controversial weapon" against delayed HMO payments, some doctors are now treading new ground in asking their patients to step into the fray and convince their insurers to pay up, the Wall Street Journal reports. As physicians retaliate against the prolonged payment delays that leave some "short tens of thousands of dollars," the new tactic has earned the ire of medical ethicists who fear the deterioration of the physician-patient relationship. Physicians must understand that "your patient should not be your lobbyist," said Arthur Caplan of the Center for Bioethics at the University of Pennsylvania. The nature of the relationship means that patients "aren't in a position to resist requests" from their doctors, Caplan said, pointing to the patient-physician bond based on trust. The Journal reports that some physicians also worry that patients "may even be reluctant to continue treatment, feeling chastised and embarrassed when a doctor complains, and even fearful that their care will be affected." The problem of late payments seems to be "worse than ever," the Journal reports, as the New York State Insurance Department recently fined Oxford Health Plans , Aetna U.S. Healthcare and "a dozen other insurers for violating the state's law for speedy payments." For their part, most insurers claim prompt payment and blame half of all pending claims on inadequate claims data. Health Insurance Association of America President Chip Kahn says that most insurers pay up promptly, and doctors' efforts to involve patients in the disputes "are a potential abuse of the relationship" (Jeffrey, 6/23).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.