As the cost of care increases, access to quality health care services continues to decline. HMOs denied 4 million health care claims in 1999. Only 324 of these denials have been reviewed by the HMO appeals panel since 1997. Health care consumers are afforded less protection than buyers of automobiles, televisions or other products. Other states, including Texas and California, have already taken steps to hold HMOs legally accountable when they deny necessary medical care.
Grant patients the right to sue health insurers for denying care.
Require additional oversight of HMO quality of care and accountability. Guarantee access to affordable prescriptions for all New Jerseyans. Make HMO appeals panel decisions legally binding. Provide consumer health care education. Increase access to health care for uninsured New Jerseyans.