Politics & policy

Insight into federal and state health care legislation & CMS regulation

Several HMOs Stung in N.Y. Test Of Consumer Law

More than half of 31 HMOs in New York state failed to properly respond to telephone requests for information they are legally required to provide, according to Attorney General Dennis Vacco.

The state's Managed Care Consumer Bill of Rights, enacted last year, includes a requirement that plans provide subscriber contracts and member handbooks upon request. To test compliance with the law, the attorney general's office set up a survey of 31 HMOs. Each plan received 16 telephone requests for information. Eighteen of the plans failed to provide the information more than half the time, while five plans provided the information at least 14 times.

Vacco served notice on the 18 that failed the test that they could be sued. Each of the 18 plans, which include Cigna Healthcare of New York, Empire Blue Cross and Blue Shield and Prudential Health Plan of New York, scheduled a conference with the attorney general's office. The HMOs will be asked to sign an agreement on how each plans to comply with the law. The attorney general's office also seeks to put a financial penalty in the agreement.

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