COPE-1, AM '04, PROGRESS REPORT, COUNCIL ON PRACTICE ENVIRONMENT

RES-16-P, AM '03, Hospital and Network Physicians:

RESOLVED, that the Board of Directors shall study the issues surrounding disclosure to patients of non-participation of hospital based physicians including:

1. Existing laws governing emergency care;
2. Contractual issues between patients and health plans, both ERISA and non-ERISA regarding financial liability for services rendered by non-participating physicians;
3. Determination of whose duty it is to make the disclosure; and be it further

Resolved, that the Board of Directors develop a solution to the defined problem.

Response: COPE discussed this resolution and reviewed legislative activities addressing this issue. The problem was discussed at the 2004 individual health plan meetings without any success. Due to the pending legislation at the time of the individual meetings, discussions were tabled until the legislative session was concluded. At the end of this legislative session, the Division of Insurance was directed to convene hearings on this issue to develop possible solutions to the problems and report back to the legislature.