HMO Patients Get New Rights Today

Article excerpt

ATLANTA -- Last year, Roy Barnes gained national fame with political ads that made what appeared to be a commonsense statement: If you can choose who changes the oil in your car, you should be able to choose your doctor.

The inference was that patients in managed care plans can't.

He became governor repeating that message, and starting today, the 1.5 million Georgians receiving medical treatment through managed care get a consumer champion, new legal rights and new choices under HMO reform laws taking effect.

However, it's too early to tell how much the new laws will benefit consumers, and how much they'll cost, according to industry experts and health care advocates.

The new type of policies for Georgians in managed-care plans that will allow them to see the doctor of their choice won't be available until Jan. 1, and could cost up to 17.5 percent more in premiums and/or include more out-of-pocket expenses for consumers.

Customers will be able to sue their HMOs for denying or delaying medically necessary coverage, but not before going through potentially lengthy company and external appeals.

And the new consumer advocate, Cathey Steinberg, will be able to publish health insurance rates and information but only contest car and homeowners insurance rates.

In the end, said James Purcell of the Georgia Managed Care Association, premiums may go up to pay for the administrative costs associated with the laws, such as the review panel for consumer/HMO disputes.

"With the liability bill, I think it could increase costs," said Bert Fridlin, state director of the National Federation of Independent Business, an organization that raised concerns about Barnes' HMO package. …