Abstract

On September 25, 2002, California Governor Gray Davis approved the Health Care Providers’ Bill of Rights. The legislation, which went into effect January 1, 2003, outlaws several practices by insurers that physicians complained represented an imbalance of power. Insurers are now unable to compel doctors to take more patients than they feel they can handle, and managed care companies cannot unilaterally change the terms of their contracts with doctors without notice. Governor Davis praised the legislation, stating, “in order to provide patients with world-class care, we must ensure that our doctors have world-class rights.”California has one of the highest levels of health maintenance organization penetration in the nation, at 52 percent. Seventy-eight percent of HMO patients are enrolled in five HMOs. As a result of these practice conditions, doctors reportedly often felt pressured to comply when HMOs “ordered [them] to take on additional patients,” “changed contracts without warning,” and were “lax in payments.”