Consumer Protection in Private Health Insurance: The Role of Consumer Complaints. F. Public Education Activities



The MIA has published a brochure titled "Need help with your HMO" which provides advice on the new Appeals & Grievances Law legislation and includes contact information for the MIA. The MIA website does not list any other health insurance publications.

The HEAU produces a range of brochures, guides and consumer tips including "When your health plan says 'no', "Making the most of your health insurance" and "Sorting out medical bills".

Outreach and Media

The Commissioner and senior MIA staff receive frequent inquiries for speaking engagements on complaints management, with a growing focus in the MIA towards consumer education. The Commissioner is very active in both the legislative and provider community, with press coverage resulting in growth in complaints. While the Annual Report of the MIA is tabled in the General Assembly, the Commissioner will publicize issues with complaints on an ongoing basis throughout the year, as they arise.

Staff of the HEAU undertake about 20-25 speeches to consumer groups annually and also staff information booths at fairs and other public events. However there is an information gap with consumer groups not particularly well focused and not actively using the HEAU office.

Following the passage of the appeals legislation, there has been quite strong demand from provider groups for HEAU staff to speak at public events. Mental health providers are the most well organized. Some other health professionals, including surgeons, have been much less active in using the legislation. Often it is the office practice managers who will be involved in handling patient complaints concerning insurance. However there are problems with poor communication between some professionals and their office practice managers. In one recent instance the State medical society sent information on the new appeals process to all its members. In a large radiology group practice comprising 95 radiologists, all the radiologists received this information but not one passed it on to the practice manager. The HEAU is now undertaking outreach activities to office practice managers, given their central role in patient complaints.