NCPA - National Center for Policy Analysis

Delays Even With Patients' Rights Bill

July 6, 1999

Three years after New York State enacted a sweeping Managed Care Bill of Rights, a survey of New York City doctors suggests that abuse by managed care companies have grown worse.

Doctors said managed care companies do not appear to be increasing outright denials of medical treatments, but "create such a confusing and frustrating gantlet for obtaining permission that medicare providers are often discouraged from trying."

The state laws regulate everything from the information insurers have to disclose to how quickly they are supposed to return phone calls. The regulations are similar to laws in a few other states and a national plan supported by President Clinton. According to Mark Green, the city's Public Advocate, a survey of 257 doctors in May, conducted by his office and the New York County Medical Society, found:

  • Many parts of the law are being routinely ignored by managed care companies, said survey respondents, despite undercover surveillance by state health officials, and penalties including fines and 12 percent daily interest charges.
  • This has led to delays in procedures that doctors consider medically necessary, and in some cases, doctors reported patients were forced to wait on operating tables during minor surgeries while waiting for insurers' okay.
  • And over the last two years, insurers have added a range of minor procedures and tests that require preauthorization, including X-rays.

Green says doctors reported that nearly all routine, nonemergency requests are approved within the law's three-day limit, but managed care companies commonly take much longer to approve more complicated, expensive procedures.

Source: Randy Kennedy, "Long Delays by H.M.O.'s Cited in New York Report," New York Times, July 6, 1999.


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