WPCNR’S ADAM HOME FROM ALBANY. By Assemblyman Adam T. Bradley, 89th A.D. June 26, 2004: Accessing quality health care can be confusing and time-consuming. But there are ways to make it work better. That’s why I supported legislation that would set penalties for violations of the Managed Care Bill of Rights, and speed up health care claims. This legislation holds health care companies to a higher standard and gives people help in understanding their coverage.
The Managed Care Bill of Rights provides consumers protection from unfair practices by HMOs, however, there are currently no monetary penalties for violations. The Assembly’s legislation would establish fines of between $500 and $5,000 – depending on the severity of the violation – for defying the Managed Care Bill of Rights (A.8604).
As the law stands now, there is little to deter managed care providers from taking advantage of people. The Asssembly’s legislation would put teeth in this vital law that protects people who have managed health care coverage.
Another bill the Assembly passed:
· promotes prompt and fair resolutions of health care claims;
· establishes a system for the resolution of claim disputes; and
· creates a fund for the payment of claims in case a health plan lacks the money to pay claims (A.6844-A).
Many times people wait months and months for the results of their health care claims, only to find out they aren’t going to receive as much money as they are entitled to. This is simply unacceptable. By speeding up the claims process and ensuring that a fair amount of money will be paid, this legislation makes sure consumers aren’t paying for HMO shortcomings.
In addition, I support legislation that creates the Managed Care Consumer Assistance Program (A.4454-A). The MCCAP would provide comprehensive information about people’s managed care choices, rights and responsibilities. It would also help consumers quickly resolve questions and complaints about their care.
The number of New Yorkers enrolled in managed care organizations continues to rise sharply. The Managed Care Consumer Assistance Program would help people navigate the sometimes confusing world of managed care and ensure they are receiving a high quality of service.
Ensuring patients receive quality care and that consumers are not ripped off by HMOs is one of our most important issues.