December 1998 Bulletin

In Brief

California

The California Department of Corporations (DOC) denied an administration petition filed by the California Medical Association (CMA), charging that the agency has failed to take action against health plans that place unfair and illegal provisions in their contracts with physicians. CMA will file an appeal and if unsuccessful will consider other legal action against DOC. CMA is also asking DOC to holds health plans ultimately responsible for paying for the care their enrollees receive, even if they subcontract with medical groups, independent practice associations or physician practice management companies.

Texas

A federal judge in Houston has agreed to stay her ruling that federal law preempts the state's process for reviewing appeals of adverse benefits rulings by managed care organization until a higher court rules on an appeal by the state Attorney General.


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