California limits HMO wait times

Jan 19 2010

The Los Angeles Times reports that under new rules to be announced Wednesday, and to be phased in over the next year, California is setting limits on HMO wait times: "The regulations by the California Department of Managed Health Care, in the works for much of the last decade, will require that patients be treated by HMO doctors within 10 business days of requesting an appointment, and by specialists within 15.

Patients seeking urgent care that does not require prior authorization must be seen within 48 hours. Telephone calls to doctors' offices will have to be returned within 30 minutes, and physicians or other health professionals will have to be available 24 hours a day. California says it is the first state to set time standards for HMOs, which serve nearly 21 million of its residents" (Helfand, 1/19).

The Associated Press/The Boston Globe reports on dentists' efforts to emphasize prevention and fluoridation: "New Hampshire dentists are encouraging primary care physicians to perform more oral health screenings and urging more communities to add fluoride to their public water supplies. In a report being released Tuesday, the New Hampshire Dental Society outlines five goals aimed at improving oral health in a state where 39 percent of the population lacks dental insurance, less than half the public water supplies are fluoridated and many children don't get dental care" (Ramer, 1/18).

San Antonio Express-News reports on efforts to get a separate children's hospital in the city. Proponents of a plan are in talks with the city's hospital but so far there is no specific agreement. "San Antonio may have a nearly $20 billion medical and bioscience industry, but it has no freestanding children's hospital. ... For San Antonio's medical sector, a children's hospital means the ability to recruit and keep pediatric specialists. For many families, it means being able to receive care in one place, or not having to take a sick child to an out-of-town hospital" (Allen, 1/18).

The Austin American-Statesman reports on a new HIV-testing law that focuses on pregnant  women: "A gap in the way Texas cared for pregnant women sometimes cost some of the state's most innocent residents -- newborn babies -- their lives. To remedy that, part of a law that took effect this month requires health care providers to test pregnant women for HIV, the virus that causes AIDS, at some point during the last three months of pregnancy unless the woman objects. Mothers-to-be generally will be billed for the test, the cost of which varies depending on who does it. The cost is expected to be covered by insurance or Medicaid, said Allison Lowery, a spokeswoman for the Department of State Health Services. Before the law, the state required doctors and other medical providers to test pregnant women for HIV at the first prenatal visit and at the time of birth. But because a woman's HIV status can change during her pregnancy, potentially without her or her doctor knowing it, by the time she goes into labor, it could be too late" (Roser, 1/18).

The New York Times reports on efforts to combat diabetes in New York City: "Starting in February, the Visiting Nurse Service of New York will begin a pilot program to try to combat Type 1 diabetes in young people by offering more personalized health care — and to the young people, ages 11 to 17, who enroll, they are offering specially programmed BlackBerrys" that "are, to some extent, a hard, cold incentive: participate in this diabetes care management program, and get a hot gadget. But the BlackBerrys will have been programmed specifically to help young people monitor their health, so that instead of writing in some notebook what they're eating and how they feel, the young people can do it on their phones, looking like they're blithely texting a friend instead of trying to avoid the emergency room" (Dominus, 1/18).