Missouri Clarifies Provisions of New HMO Choice Rules


Missouri's insurance department has spelled out exactly what HMOs in the state have to do to comply with employee choice provisions of regulations passed last year. Insurance Director Jay Angoff sent a bulletin to the more than 30 state-licensed HMOs specifying the choices they must offer to members of plans covering 50 or more workers.

Angoff said HMOs could comply with the law in any of three ways: If they don't require HMO members to see a primary care gatekeeper physician before going to a specialist; offer a fee-for-service plan as an alternative to an HMO gatekeeper plan; or offer a modified HMO that allows unrestricted access to specialists as an alternative to an HMO gatekeeper plan. The directive applies to plans that were issued or renewed after Aug. 28, 1997, when the law took effect.

Career Opportunities

HAP, a subsidiary of Henry Ford Health System, is a nonprofit health plan providing coverage to individuals, companies and organizations. This executive develops strategies to meet membership and revenue targets through products, pricing, market segmentation and advertising.  Aligns business among Business Development, Commercial Sales, Medicare and Public Sector Programs and Product Development. Seeks to enhance and be responsible for business development and expansion through the development of an effective product portfolio, strong interpersonal relationships and service excellence.

Apply via email to jfedder1@hfhs.org or online at http://p.rfer.us/HENRYFORDlXqAJA

Subscribe to Our Newsletters

Monthly table of contents

Be notified as each issue of Managed Care is available online.

Biweekly newsletter

Recent topics have included:

PTCommunity news

New drug approvals, clinical trials, drug management. Three times per week.