New Jersey regulators found they had complaints from more than a dozen doctors accusing the HMO of lateness in paying claims. Within days, Musarra said, checks from Horizon began arriving, and the HMO apologized for the delay. After years watching the escalating feud between HMOs and doctors and hospitals, states are becoming more aggressive in making sure that plans pay claims. Many states have passed laws to specify how quickly HMOs must make payments, and they're issuing warnings to plans that don't comply. States including New York, Florida, North Carolina and Louisiana have started handing out fines.
Regulators say they're acting to protect patients.
They note some health providers illegally bill patients when an HMO balks at paying. And patients could be hurt if hospitals or doctors curtail services because of financial problems resulting from claim disputes. Barbara Murray, of Port Charlotte, Fla., said bill collectors sent by doctors and hospitals hounded her late husband as he was dying of heart disease. The health plan resisted, saying the Murrays had not paid their premiums on time, a charge the couple disputed. J.C. Murray died in 1997.