A Step In the Right Direction: CA Sets Health Care Regulations.
These groundbreaking consumer protections will help ensure that HMO patients get the care they need, when they need it. Consumer advocates argued that care delayed is often care denied, leading to worse health outcomes or unnecessary visits to the emergency room. These new first-in-the-nation patient rights will provide consumers with clear expectations about how quickly they should get in to see a doctor or specialist.
The new rules ensure that when managed care consumers agree to a limited network of providers, insurers fulfill their promise that their networks of doctors and specialists have the capacity to take care of their paying patients. While the concept of timely access to health care was one of the cornerstones of the original Knox-Keene Act of 1975 that established and regulated managed care in California, it remained largely unrealized and unenforced.
For the first time, the new consumer protections detail specific time-elapsed standards by which patients can expect to get a telephone questioned answered, an urgent care appointment, or a routine appointment for a primary care doctor or specialist.
Labels: california, health care reform, patients' rights
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