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MANAGED CARE September 1999. ©1999 MediMedia USA

NCQA has clarified how many plans publicly reported HEDIS data in 1998: 247 managed care organizations, representing 410 products, shared HEDIS data in Quality Compass ’99…. More than 6 in 10 physicians responding to a Kaiser Family Foundation survey see health plans deny prescription-drug coverage routinely; 37 percent of those say the most recent event caused patients serious harm…. Random unannounced surveys by the Joint Commission on the Accreditation of Healthcare Organizations will soon live up to their name. Beginning in January, the Joint Commission will give hospitals and other providers no advance notice of a “surprise” visit…. According to a General Accounting Office report, many Medicare HMOs do not routinely notify members of formulary changes — leaving them to learn about them at the pharmacy counter…. Get this: More than a third of respondents told an Insurance Research Council poll that it’s OK to stay home and collect workers’ comp if they’re still feeling a little pain — even after a physician says it’s all right to return to work.

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