New Jersey Proposes Tough New Rules For HMOs

In the USA, New Jersey has instituted tough new regulations for healthmaintenance organizations, which the state's Health Commissioners believe make up the most comprehensive consumer bill in the country.

The new rules require HMOs to make public any financial incentives they offer doctors to withhold care, and also prohibit them from limiting what doctors can tell patients about treatment options, including expensive ones not covered by insurance. New Jersey is also setting up an independent review panel for consumers to appeal against any decisions by HMOs to curtail or deny care.

Rules Not Binding, But Expected To Be Adhered To While the panel's recommendations would be non-binding, state health officials and consumer groups feel that HMOs would abide by the rulings in most cases. The new rules cover all those whose primary care physician is in the state, even if the person works in another state.