DMHC Must Protect Physician Groups' Financial Data
[Posted 12/19/02]
CMA leaders and senior staff recently met with Daniel
Zingale, director of California’s Department of Managed Health Care (DMHC), to
discuss physicians’ objections to public disclosure of the private, confidential
financial statements of physician organizations that have risk-bearing managed
care
contracts.
CMA brought a lawsuit earlier this year to invalidate DMHC regulations that
mandated public disclosure of physician groups’ confidential financial
information. CMA argued that the regulations would give health plans an unfair
advantage when negotiating contracts with medical groups, increasing the
likelihood of physician group bankruptcies and the resulting disruptions of
patient care. The judge ruled in favor of CMA, stating that DMHC never addressed
whether financial data disclosure would adversely affect the contract
negotiations.
CMA has since learned that DMHC is developing new regulations that will again
require full public disclosure of risk-bearing medical groups’ financial
statements. During the meeting with Mr. Zingale, the CMA representatives
emphasized that the 1999 financial solvency legislation was not a disclosure
statute but rather a framework for DMHC to collect financial information that
would help it address the solvency problems plaguing California’s physician
groups. They reiterated that disclosure of proprietary financial data would give
health plans an unfair advantage in contract negotiations.
CMA prepared and presented Mr. Zingale with a proposed compromise to full
public disclosure. Click
here to read the details of CMA’s proposal.
Contact: Aileen Wetzel, 916/444-5532 or awetzel@cmanet.org.
