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Read Making a Killing

home / healthcare / in the media

Modern Healthcare
Feb 26, 2001

by LAURA B. BENKO

Access to arbitration records sought

Sparking outrage from health plans, two California consumer groups have filed a petition to make records of arbitration hearings between HMOs and patients public information.

The petition, filed earlier this month, gives the state's Department of Managed Health Care until mid-March to decide if it wants to require HMOs to disclose all documents and discovery obtained during arbitration-a process used by many insurers to resolve disputes outside of court. Such records currently are sealed.

The groups behind the petition-the Foundation for Taxpayer and Consumer Rights and the Health Administration Responsibility Project, both based in Santa Monica, Calif.-contend that arbitration is costly to patients and unfairly tilted in favor of health plans.

More than 18 million Californians, or 80% of the state's managed-care enrollees, belong to plans that require them to forfeit their right to sue and instead must use binding arbitration proceedings to settle coverage disputes. Disputes that make their way to court via lawsuits would be public.

''Health plans should not have the benefit of secrecy for misdeeds simply because they utilize binding arbitration agreements,'' according to the petition.

Access to records of past proceedings would give patients an edge in negotiating with health plans, the groups said.

Not so, said the California Association of Health Plans. The organization argues that disclosing arbitration documents would create a hornet's nest of problems and ultimately make settlements more difficult to achieve.



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