MANAGED CARE August 1998. ©1998 Stezzi Communications
Harris Methodist Health Plan has submitted a revised physician-compensation plan with the Texas Department of Insurance that eliminates controversial fines on physicians who surpass their prescription drug budgets.
Harris Methodist, the largest HMO in northern Texas with 279,000 members, also will pay an undisclosed amount to doctors who remitted the fines. State regulators and a judge decided that the fines, which were instituted in 1995, illegally forced physicians to choose between their own financial well-being and their patients' best clinical interests.
Meanwhile, in a move that may have been prompted by the Harris Methodist case, Texas Attorney General Dan Morales is investigating three of the state's largest HMOs. Morales' office would not identify the plans it was investigating or specify what it is looking for. NYLCare Health Plans of the Southwest, PacifiCare of Texas and Prudential HealthCare told the Dallas Morning News that they have been asked for documents, including patient records, related to physician compensation and consumer marketing.