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Andrew LaMar

Sacramento – The California Medical Association today welcomed new regulations for health maintenance organizations to see patients in a timely manner but cautioned that it’s essential HMOs have enough doctors to meet the need.

“We are cautiously optimistic that these new regulations will work as intended,” said Brennan Cassidy, M.D., president of CMA. “As doctors, our No. 1 priority is our patients. We want to be sure that HMOs meet these requirements without forcing doctors to shorten patient visits or meet unrealistic quotas that would comprise the quality of care.”

As part of the regulations, HMOs are required to meet minimum physician-to-patient ratios established in the Knox-Keene Act. The Knox Keene Act requires HMOs to maintain provider networks with certain ratios of physicians to enrollees, but very little recent information on network adequacy is available because the state does not regularly monitor compliance.

“Doctors support their patients’ ability to access care in a timely manner,” Cassidy said. “Making sure that HMOs have enough doctors to meet the needs of their patients is an important step forward.”

CMA supported the 2002 legislation, AB 2179, directing the state to develop and adopt regulations ensuring that HMO enrollees have timely access to health care services. CMA has worked closely with the state Department of Managed Health Care to draft regulations that are reasonable and practical.

The timely access regulations became final this week. HMOs must demonstrate to the state how they will comply with rules by Oct. 17, and they must fully implement them by Jan. 17, 2011.

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The California Medical Association represents more than 35,000 physicians in all modes of practice and specialties. CMA is dedicated to the health of all patients in California.