Delays to see a doctor in California were reported as much as 59 days in some parts of the state during 2009. The new regulations hope to increase the care of their 21 million HMO members by decreasing these waiting times.
The regulations require general practitioners to see patients within 10 business days and there is a similar waiting time set for specialists. Doctors must be available 24 hours a day and return calls within 30 minutes. Patients with urgent needs must be seen within 48 hours.
The rules, originally authorised by a 2002 law but delayed due to bureaucratic debate, will be made public this week and phased in over the next year.
The regulations will be enforced by monitoring consumer complaints and then through audits. Regulators say that they will look for trends rather than investigating each complaint. Services that prove not to be in compliance will be assessed a fine.
HMO managers predict costs will rise, but they are not sure by how much. The responsibility for explaining excessive delays would fall on the doctors, but the doctors