>one thing, HMO's must permit a mother and new born baby to stay at
least 48
>hours in the hospital. They had been insisting they be kicked out
after 24
>hours. Of course, you need something quicker than legislation, but
the state
I've never dealt with this kind of situation, but my
inclination, were an HMO to block my access to adequate
medical treatment, might be as follows:
(1) Put on record (the kind that would stand up as evidence
in court) my objections to early discharge from care, etc.
Make it clear to the HMO that the intention of the record
is to serve as evidence in a malpractice suit should anything
go wrong. (I'd probably consult a lawyer, or even ask the
lawyer to notify them.)
(2) If an HMO administrator (non-M.D.) tells an HMO physician
how to practice medicine, doesn't this constitute unlicensed
practice of medicine? Has anyone referred such HMO
administrators
for prosecution? I'd be tempted to tell an administrator, "My
doctor says I need such-and-such, but you are telling him/her
not to provide it. Are you licensed to practice medicine in
this
state? No? Do we need to talk to the state Professional
Licensing
Board about whether you are 'practicing medicine?'"
(Question to the physicians who subscribe to this list- at
what
point do you think an administrator would cross the line
between
managing a business and practicing medicine?)
(3) I agree that no insurance company wants action taken
with the state insurance commission. I once threatened a
recalcitrant insurer (who owed me a refund on a premium,
but was ignoring my requests for payment) with this, and
got results.
-Bill
