CMA Testifies on DMHC Proposal to Scale Back HMO Oversight
[Posted 06/16/05]

CMA recently testified at a hearing on a Department of Managed Health Care (DMHC) proposal to scale back state oversight of health plans. The proposal would allow health plans that are voluntarily accredited by the National Commission for Quality Assurance (NCQA) to be “deemed” to have met California standards, exempting them from DMHC surveys. The idea was first proposed in last year’s California Performance Review study, which was done for the Schwarzenegger administration.

Although CMA agrees with the general notion that regulated entities should not be subjected to duplicative surveys, the association expressed serious concern that the DMHC surveys are not truly duplicative and by allowing “deemed” status, DMHC would be unable to provide the oversight needed to perform one of its most fundamental regulatory roles—ensuring access to care.

“The Knox-Keene Act contains the most stringent and robust patient/provider protections in the nation,” wrote CMA lobbyist Astrid Meghrigian in the comments and testimony presented at a DMHC hearing. “Given the strength of California law and the mission of the department, CMA is extremely concerned about the possibility of allowing any private entity with less stringent standards to serve as a substitute for regulatory oversight.”

In her testimony, Meghrigian stated that “health plans in California would be subject to less stringent regulation and oversight of quality of care” under NCQA surveys.

Contact: Astrid Meghrigian, 916/444-5532 or ameghrigian@cmanet.org.