West Zone: Calif. HMO Dept. Intervenes

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American Banker-Bond Buyer

The California Dept. of Managed Health Care has decided to put itself in the precarious position of arbiter in a dispute between consumer groups and California HMOs over whether or not records from HMO arbitration hearings should be made public. A petition, filed by the Foundation for Taxpayer and Consumer Rights and the Health Administration Responsibility Project, gives Daniel Zingale, head of the agency, 30 days to decide on a course of action.

Nearly 24 million California HMO members are required by their plans to resolve disputes through binding arbitration, and the consumers’ groups say access to previous hearings would aid patients in their negotiations. According to the California Assn. of Health Plans, however, those disclosures would raise grave privacy and liability issues and would, in the end, make settlements more difficult to agree on.

Consumer Watchdog
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