California patients facing problems with their HMO, concerns over their medical privacy, or questions about their rights under new state HMO reform laws can now turn to a new, free 80-page guide available from state consumer hotlines.
The California Department of Consumer Affairs (DCA), California Department of Managed Health Care (DMHC) and the Foundation For Taxpayer and Consumer Rights (FTCR) today announced the availability of the first 40,000 printed copies of the free guide, which covers issues from how to get copies of your medical records to how to sue your HMO. FTCR prepared the guide with the assistance of the two state agencies.
“The California Patient Guide: Your Health Care Rights and Remedies” is an unprecedented collaboration between FTCR, DCA, DMHC, the California Nurses Association, the California Medical Association, the Consumer Attorneys of the California, state legislative offices, and medical and legal experts across the state. In question and answer format, the guide focuses on informing patients of how to use new HMO patient rights’ laws effective this year, including the right to have denials of care reviewed by independent experts and the right to pursue legal action against an HMO.
“A patients’ bill of rights is meaningless unless HMO patients know about the new laws and how to use them,” said Jamie Court, executive director of FTCR. “The patient guide is a tool and a compass for HMO patients who too often find themselves alone and without leverage or direction when confronting billion dollar corporations with nearly unlimited resources. It signals a positive, new direction for California’s HMO regulation when state regulators are willing to collaborate with doctors, nurses, and patient advocates to produce and distribute an owner’s manual for the vehicle of patients’ rights.”
Funding from The California Wellness Foundation allowed for the guide’s preparation. For every right enumerated, the guide provides the specific state statutes for patients to cite when seeking care from their HMOs. It includes, among other things, information on patients’ rights:
‘ in the emergency room
‘ to obtain their medical records and to maintain medical privacy;
‘ to effectively navigate through their HMO’s appeals process,
‘ to have a second opinion;
‘ to have a independent party review of denials of treatment by HMOs;
‘ to health coverage for pre-existing conditions;
‘ to file a legal claim against the HMO.
The public can secure the guide by calling 1-888-HMO-2219 (Department of Managed Health Care) or 1-800-952-5210 (Department of Consumer Affairs). An Internet version can be viewed at http://www.calpatientguide.org
“The Wellness Foundation is proud to fund this unprecedented collaboration between consumer groups, patients, state agencies, the medical community, the legal community and legislators,” said Gary Yates, president of The California Wellness Foundation. “This guide should prove an invaluable tool for patients in need of help.”
The guide was presented Monday in San Francisco at the headquarters of the California Medical Association (CMA). The CMA will distribute the guide to its membership. “We have worked hard for patient rights and now there finally is a resource that encapsules them in one place,” said CMA CEO Dr. Jack Lewin, who heads the 35,000-member physician organization. “We will distribute the guide to our members to make it available in their offices.”
The Foundation for Taxpayer and Consumer Rights is a non-profit, non-partisan consumer watchdog group based in Santa Monica, CA. http://www.consumerwatchdog.org.