Calif. rules on MD visits through HMOs still stalled

Six years ago, California passed a new law requiring that HMO patients get timely appointments with their doctors. State regulators thought they had licked the problem--but they were a bit too optimistic, to say the least. To date, the rules still aren't in force, a problem which won't be solved until at least late this year.

In 2007, the state's Department of Managed Health Care at least made a start, releasing proposed rules for HMO doctor access. They included a requirement that plans provide appointments for diagnostic testing within 24 hours, for urgent physical therapy within 72 hours and for preventive care with a specialist within 22 days.

However, HMOs and physician groups objected to the agency's proposal vigorously, arguing that it wasn't smart to further regulate physician relationships with consumers. Eventually, DMHC threw up its hands and decided to let health plans come up with their own proposal. Now, the health plans have until October of 2008 to issue their own compliance plan. The agency will then review the rules.

To learn more about this debate:
- read this piece from the Los Angeles Times

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