California law requires plans to give notice of contract changes

The doctors' bill of rights is a "step in the journey," according to the state's medical association.

By Julie A. Jacob, AMNews staff. Oct. 21, 2002.

California Gov. Gray Davis has signed into law a bill that prohibits health plans from making unilateral contract changes, instead requiring plans to give physicians advance notice of any proposed changes and allowing physicians to negotiate them.

The Health Care Providers' Bill of Rights (AB 2907), also prohibits health plans from requiring physicians to accept patients beyond the number specified in the contract if the physician thinks that would limit patients' access and prohibits plans from requiring doctors to waive provisions of the Knox-Keene Act, which regulates HMOs in state.

Daniel Zingale, director of the state's Dept. of Managed Health Care, said the new law "is a significant step forward for doctors and patients."

"There have been problems reported [to the department's complaint hot line] all around the state where health plans have changed contracts mid-course," said Zingale. "Doctors will also have the final word on how many patients to see each day, which is probably the biggest quality issue."

Jack Lewin, MD, CEO of the California Medical Assn., called the law "a great bill" but added that it is only "a step in the journey" in improving contracting issues between physicians and health plans.

"It is [only] a step toward it because health plans will disregard the law, as they have the Knox-Keene Act [regulating HMOs]. What it does, by specifying the Legislature's intent, is to serve as a guide for the courts and the Dept. of Managed Health Care to enforce the law and protect physicians and patients," Dr. Lewin said. [...]