Santa Monica, CA — The Foundation for Taxpayer and Consumer Rights
(FTCR) sent a letter to the state’s HMO regulator calling for swift
action to end Blue Cross’ practice of conscripting doctors as "double
agents," combing medical records for any excuse to dump patients who
might become ill.
Governor Arnold Schwarzenegger told the Los Angeles Times on
Wednesday that the practice should be banned. Schwarzenegger’s office
was copied on the letter sent to regulators.
"Governor Schwarzenegger should not let go of this issue until
his Department of Managed Health Care has established a clear and
comprehensive prohibition on HMO strategies to dump sick patients who
need health care the most," said Jerry Flanagan of FTCR.
In the letter FTCR wrote:
"We urge you to advise all health plans that they must refrain
from forwarding a member’s enrollment application to their treating
physician, and asking that physician to utilize administrative or
financial judgment about coverage issues that are typically functions
of underwriters and utilization reviewers.
"Blue Cross’ announced voluntary cessation of the practice
should not stay your hand. Absent swift and final action by you, Blue
Cross will likely return to the profitable practice in the future, and
other insurers may adopt it if they have not done so already.
"Not only do Blue Cross’ actions have a chilling effect on the
doctor-patient relationship, they violate the legal and social
framework of our health care system — the principle that medical
decisions are to be rendered unhindered by fiscal and administrative
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FTCR is California’s leading public interest watchdog. For more information, visit us on the web at: www.ConsumerWatchdog.org.