Zingale, DMHC Receive Praise in Early Going
Having served as head of the Department of Managed Health Care since its inception last July, Daniel Zingale has drawn generally favorable reviews for his department's oversight of HMOs, the San Francisco Chronicle reports. The DMHC was created as part of a "sweeping package of more than 20" HMO reforms enacted last year. Armed with a $40 million budget and a staff of 300, Zingale has set out to improve both patient protections and relations between patients and HMOs. So far the DMHC has issued to HMOs eight fines totaling $275,000, and recently it turned Healthdent of California Inc. "over to a conservator because of the plan's severe financial problems."
And while Zingale "rejects any notice he has been soft on the health plans," industry officials say that he has been fair in terms of enforcement. Walter Zelman, president of the California Association of Health Plans, said, "I don't think anyone in any plan thinks we have a weak regulator or an inactive regulator on our hands. They are hopeful we have a thoughtful regulator who will keep an open eye and keep an open ear." Patricia Siegel of Kaiser Permanente said: "While the outcome isn't always what we'd desire, I have found they're very open. The tone has been set for a cooperative working relationship. We understand they are the regulator, and, if they have to, they will take the hard actions. As a health plan, that's OK with us." The DMHC has also instituted a 24-hour "HMO Help Center," which offers advice over the telephone to HMO members and occasionally intervenes in disputes between patients and plans. The help center is just one way Zingale has helped to increase the state's response to patient complaints. Larry Levitt, a vice president of health policy for the Kaiser Family Foundation and member of the DMHC's advisory board, said, "It's truly like night and day compared to the old regime under the Department of Corporations. [Zingale] has put the department on the map."
The Chronicle reports that despite these commendations, the "department is in a honeymoon phase and hasn't yet tackled some of the industry's biggest problems," such as shoring up the state's ailing physician groups. Steve Thompson, vice president of government affairs for the California Medical Association and another member of the advisory board, praised the DMHC for its work in patient protections, but said, "They haven't yet come to grips with the basic fundamental financial problems of the health care system." And Jamie Court of the Foundation for Taxpayers and Consumer Rights said he would like Zingale to be tougher on HMOs when they make mistakes. Court said, "We're looking for this guy to wield a stick and make sure these HMOs behave. He's a sheriff, and we haven't really seen his star or a gun." Zingale, however, says he would rather work with HMOs than portray them as "bad guys." He said, "Everyone is recognizing this is a new era, and I include the plans in this" (Colliver, San Francisco Chronicle, 1/28).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.