New York's highest court of appeals has held that no-fault insurers cannot deny no-fault benefits where they unilaterally determine that a provider has committed misconduct based upon alleged fraudulent conduct. The Court held that this authority belongs solely to state regulators, specifically New York's Board of Regents, which oversees professional licensing and discipline. This follows a similar recent ruling in Florida reported in this publication.
Managed Satisfaction
While Health Maintenance Organizations (HMOs) may not be popular with health care providers, consumers often prefer them. A survey that queried 10,000 consumers found the following percentages completely or very satisfied:
Health Plan Satisfaction
HMOs - 63.6%
PPOs - 50.0%
Traditional Plans - 55.1%
Medicare Only - 40.7%
Percentage of consumers completely satisfied or very satisfied with their health plan.
SOURCE: National Research Corp. survey.