N.Y. suit fights increasingly common HMO 'gag rules.'(managed care contracts' rules on physician-patient communications)

Article Abstract:

A New York League of Physicians and Surgeons' suit against the New York State Dept. of Health underlines dissatisfaction with HMOs' contract provisions, the so-called 'gag rules', that limit physician-patient confidential communications. Other states also require restrictions on managed care contracts' confidentiality clauses regarding unauthorized treatments or health plan participation. Confidentiality clauses might affect physicians' First Amendment rights and ethical principles of the physician-patient relationship.

Contracts, Confidential communications, Physician-patient privilege

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HMOs without gatekeepers

Article Abstract:

Health maintenance organizations (HMOs) are using both the gatekeeper model and the open access model to provide health care services to their customers. The gatekeeper model, which is considered to be synonymous with managed health care offered by HMOs, is increasingly being challenged by the open access model. United Healthcare, the largest operator of HMOs using the open access approach, reports that the open access model is very similar to the gatekeeper approach in terms of costs.

Methods, Economic aspects, Managed care plans (Medical care)

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Busting HMO 'gag' clauses - how Colorado did it

Article Abstract:

'Gag' clauses are a key concern for physicians employee by health maintenance organizations (HMO). The controversial clauses restrict patient-doctor communication based on the economic concerns of the HMO. Colorado doctors successfully lobbied the state of Colorado to require HMOs to eliminate 'gag' clauses from physicians' contracts. The final bill, HB 1216, was enacted on Apr 25, 1996.

Regulation, Licensing, and Inspection of Miscellaneous Commercial Sectors, Offices & clinics of medical doctors, Physicians & Surgeons, Offices of Physicians (except Mental Health Specialists), Business Aid & Regulation-State, Political activity, Column, Physicians, Medical professions, Social policy, Colorado, Industry regulations, Business assistance

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