YOU ARE HERE: LAT HomeCollections


Emergency care and HMO profits

October 26, 2008

The Schwarzenegger administration has chosen to jeopardize Californians' access to necessary emergency care in order to protect the bottom line of for-profit health maintenance organizations. ("Hospitals protest new rules on billing," Oct. 15.)

For-profit HMOs have been refusing to pay the bill for emergency services provided to their policyholders by out-of-network doctors and hospitals.

This refusal left many Californians facing a bill they rightly thought their insurance company was going to pay.

Other states require HMOs to pay the bill for these services.

But the California Department of Managed Health Care -- the agency that is supposed to regulate and oversee the HMOs -- passed a regulation that allows, supports, encourages and protects the continued for-profit HMO malfeasance of denial of full payment for their policyholders' emergency care.

The result is a drain of critical resources away from our already strained system of emergency care in California.

Instead of protecting for-profit HMOs and their multimillion-dollar executive compensation packages, the governor should insist that they spend their premium dollars building adequate networks of contracted doctors and facilities to provide the care they have promised to their policyholders.

Howard R. Krauss MD,


L.A. County Medical Assn.

Los Angeles Times Articles