Arbitration data to stay private, health czar rules

Published on

The San Diego Union-Tribune

Saying he lacks the authority, the state’s managed-care czar has denied a petition by consumer advocate groups to make arbitration decisions public.

Daniel Zingale, director of the state Department of Managed Health Care, denied the petition filed last month by two consumer groups.

The petition sought to make public all documents and discoveries obtained during arbitration hearings between health plans and their members. Such records are not available to the public.

Zingale said state law specifically bars publicly disclosing information about patients, and only legislators and Gov. Gray Davis can change that.

“Our role is to reform the grievance process as it affects patients,” he said.

But Jamie Court, executive director of The Foundation for Taxpayer and Consumer Rights, who co-petitioned Zingale in February, disagreed.

“We believe (Zingale) has the power to make arbitration records public. He’s reading the statute very narrowly,” Court said.

The petition came on the heels of a report by the California Research Bureau, the research arm of the state Legislature, stating that more than 18 million Californians — 80 percent of the state’s managed-care enrollees — belong to health plans with binding arbitration clauses in their contracts.

Arbitration is a process used by health plans, as well as employers, to resolve differences outside of a courtroom.

While supporters of the process say arbitration saves money and time, the California Research Bureau reported that arbitration is deeply flawed and too often works in favor of health plans.

The state managed-care association disputed the report, saying it erroneously theorized health plans were understating arbitration cases. The main author of the report also told Modern Physician, a health magazine, that the data used for the study were flawed.

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