Letter Asks Gov. Davis To Meet With People Harmed By Their HMO

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Associated Press

SACRAMENTO — A group of HMO patients asked Gov. Gray Davis on Friday to meet with them to discuss their concerns about managed-care legislation.

Last month, a group of business and labor leaders met with Davis behind closed doors to discuss proposed changes in California’s HMO oversight.

The Legislature is considering dozens of bills that would change the state’s regulation of managed-care plans. The governor has said he will sign only a handful.

Nearly all of those participants were Davis campaign donors, an Associated Press Review found.

Patients, doctors and consumer activists were not included in the invitation-only meeting. Still, the meetings received considerable attention because the stakes in HMO reform are high: About 20 million Californians are covered by health maintenance organizations and other managed-care plans.

In a letter mailed Friday, 47 patients asked Davis “to talk with us so that you can more fully understand the plight of patients who have been denied and delayed medically necessary treatment, but have no remedy, because they have private industry health coverage.”

The letter, on Foundation For Taxpayer and Consumer Rights stationery, includes signatures from Nick Parrino of Sante Fe Springs, a father who said his son died after his HMO denied therapy to prevent his tumor recurrence; and Patricia Berry of La Mesa, who said her father died from a heart condition following surgery delays by his HMO.

Davis spokeswoman Hilary McLean said the Davis administration had not yet seen the letter and could not comment before reviewing it.

The discussion during the July 20 meeting focused on four areas, including whether California should let patients sue their HMOs for damages. Participants also discussed which state agency should regulate managed-care plans; whether there should be a health-care “ombudsman” in that agency; and how to give consumers outside reviews.

No concrete decisions emerged from the session.

The consumer group is urging Davis to approve legislation that would give patients the right to sue an HMO for damages.

“Because you have yet to sit in a room with HMO patients, you fail to recognize that only the threat of significant damages changes HMO behavior and deters wrongdoing,” the letter said.

The group asked Davis to respond within a week.

Consumer Watchdog
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