CONTACT: Andrew Pontious 310-392-0522 x308
California HMO Patients Limited to
Pre-Dispute, Binding Arbitration
Launch "HMO Arbitration Abuse
Report" Campaign
New Story & Picture Faxed Daily To Every Legislator
The Foundation for Taxpayer and Consumer Rights today
launched an "HMO Arbitration Abuse Report" campaign to
reveal daily the stories of patients harmed by their HMOs, yet
forced to have their disputes settled in private, HMO-controlled
arbitration hearings. Patients can be forced into mandatory,
binding arbitration as a condition of joining an HMO or managed
care health plan prior to any dispute arising.
The picture and story of another arbitration abuse victim will be
faxed and delivered daily to every member of the California
Assembly and Senate and to opinion leaders.
California Assembly Bill 1751 (Kuehl), sponsored by FTCR,
guarantees that HMO arbitration be voluntarily entered into only
after a dispute arises. This follows the 1998 recommendations of
a commission of the American Arbitration Association,
American Bar Association and American Medical Association.
Under state HMO liability legislation, passed in 1999 and to
take effect in 2001, patients will be able to recover damages
from an HMO that interferes with the quality of their care. But an
HMO enrollment contract can still force patients into a private
arbitration system controlled by private lawyers, rather than by a
judge and jury.
"Patients deserve the day in court that HMO liability legislation
promised them," said Andrew Pontious, a patient advocate for
FTCR, who researched and wrote the arbitration abuse reports.
"Just because a patient joins an HMO should not mean that they
have the courthouse doors closed to them. The right to sue an
HMO should mean the right to trial."
Forced arbitration can be lengthy, costly, unfair, and
conceals quality of care violations from public scrutiny.
* Arbitrators often depend on repeat business from HMO
corporations and are more likely to rule in their favor.
* Patients complain of abuse and delays by attorneys who are
not subject to discipline by judges.
* Arbitrators generally charge $100-$400 per hour, compared
to $350 per day generally for court costs.
* None of the abuses or documents uncovered in the process
are public record.
* There is no media scrutiny, publicly accountable judge, or jury
of one's peers.
* There is judicial review only in cases of outright fraud, not
judicial error.
The first "HMO Arbitration Abuse Report" is Peter Berman of
Los Angeles whose wife died of cancer due to HMO
cost-cutting. Berman did not know until his wife Renee's medical
problems developed that his HMO, Health Net, would claim the
family had signed away their right to trial
###