The Clinton administration has shelved a plan to restrict the ability of health maintenance organizations to reward doctors for limiting care offered to Medicare and Medicaid patients, The New York Times reported Monday.
The rules, designed to ensure that elderly and poor people were not denied medically necessary care, were issued March 27 and were to go into effect May 28. They were first delayed, then shelved following protests by HMOs, the report said.HMOs, including Kaiser Permanente, Aetna, Humana and the Health Insurance Plan of Greater New York, said the rules would force the companies to rewrite contracts with tens of thousands of doctors, the report said.
The companies argued that the government failed to understand the importance of financial incentives in the intensely competitive industry, the newspaper said.
According to the report, the government said in a letter mailed to HMOs May 28: "We realize this compliance date is unrealistic." The letter also said that no enforcement actions would be taken before Jan. 1, 1997.
Among the key provisions of the shelved plan was a rule prohibiting HMOs from making specific payments to physicians to limit or reduce medically necessary services to a specific enrollee.