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Group chides Bush for HMO panel vacancies

A consumer group raises the issue to drum up support for measures that would allow consumers to sue HMOs.


© St. Petersburg Times, published March 28, 2000

TALLAHASSEE -- It was one of Gov. Jeb Bush's few forays last year into the realm of HMO reform: He pushed to add a consumer advocate and a physician to the state panel that reviews patients' complaints about their HMOs.

But nearly nine months after the idea became law, the governor has yet to make the two appointments to the Statewide Provider and Subscriber Assistance Program. This, despite the fact that the agency charged with regulating HMOs maintains it has twice reminded the governor that the positions he helped create remain vacant.

Bush spokeswoman Elizabeth Hirst said Monday that "the panel and these positions are important to the governor -- he's committed to better health care and reforming our health care."

Hirst could not explain the delay, except to say that "as with all his appointments, he's always looking for the best candidates." She said Bush expects to review applicants' resumes next week.

A consumer group raised Bush's failure to fill the positions Monday in an attempt to drum up support for measures that would allow consumers to sue and collect damages from HMOs that improperly deny care. Their criticism came as a special joint committee of the Senate continued to discuss, but take no action on, a host of bills aimed at cracking down on the HMO industry.

Bush has opposed giving consumers the right to sue, and other opponents point out that the Statewide Provider and Subscriber Assistance Program already gives consumers the right to appeal HMOs' decisions to deny care. A recent Agency for Health Care Administration study reports the panel decides in favor of HMOs 51 percent of the time.

The Agency for Health Care Administration, which oversees the state grievance panel, has been working on getting the two vacancies filled since the law took effect in July of last year, said spokesman Pat Glynn. "We contacted the governor in August and November." Currently, the panel is composed of three Agency of Health Care Administration appointees, three Department of Insurance employees, their alternates and a team of rotating medical specialists.

But Sylvia Torgan, chairwoman of the Patients' Bill of Rights Coalition, said that even if the vacancies are filled, appealing an HMO's decision to deny care is a time-consuming process that only adds to the stress of the sick. The only way HMOs will provide the care patients deserve, she said, is if they can be held financially accountable in court.

"A patient who is sick now has to go through a three- or four-tier consumer grievance process," Torgan said. "We are just not going to tolerate the kind of health care system that we have today."

But despite widespread support in the polls for HMO reform, several lawmakers expressed doubts Monday that anything meaningful will pass.

"The clock is running and the clock is not our friend," said state Sen. Jim King, R-Jacksonville.

Democratic lawmakers were more cynical. While the Senate studies the issue of suing HMOs, the House leadership is opposed.

State Sen. Steven Geller, D-Hallandale, wondered whether all the debate was only a political ploy. His prediction: Both the Republican-controlled House and the Republican-controlled Senate will pass a bill, but won't be able to work out their differences, meaning nothing will become law.

"But we'll all be able to go home and say we voted for HMO reform, knowing that nothing is going to pass," he said.

The state's most powerful interest group, which fears rising health care premiums, also was confident that the Legislature will not give consumers the right to sue.

"If they do all these bills, there won't be HMOs," said Jodi Chase of Associated Industries of Florida.

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