d HMO’s and that is why there are constant questions of why they should be regulated. People need to consult their health care providers and get a better understanding of what is provided and what is not, so later there is no confusion of what type of care they should have received. Another problem lies in selective-contracting. This is a process where hospitals deny treatment to patients because their HMO is not on the hospital’s provider list. The patients usually pay capitation fees and fee-for-services (FFS). These costs are at a fixed rate and patients are provided specific care at the best possible quality. “Selective contracting is common in managed care throughout the United States. It was created so that managed care could negotiate discount prices for physician, ancillary, and hospital services.” [1] These contracts provide people with quality service at fixed costs. It maintains stability and faith between patients and their HMO’s. Control and implementation of forced regulations is another important issue. Many health care plans include gag clauses in their contracts with physicians. Gag clauses impose contractual limitations that interfere with physician-patient relationships. They include types of contract clauses that limit a physician’s ability to advise patients of all medical appropriate treatment options. They include extent to which these different types of clauses exist in current HMO contracts with physicians. They are likely to implicate contract language on physicians’ practice. In 1996, the American Medical Association’s Council on Ethical and Judicial Affairs stated that gag clauses were an unethical interference in the physician-patient relationship. Several states have taken action against these clauses in effort to strengthen consumer protections in managed care programs. The federal government has also taken action against gag clauses by notifying HMO’s...
