• Government
• Profession
• Business
• Opinion
• Health

• Health reform
• H1N1
• P4P
• EMRs
• Medicare
• Liability
• AMA House
• » More

• Book Excerpt
• Business Pitch
• Meetings
• » More

• Contract Language
• Ethics Forum
• In the Courts
• Practice Management
• Technically Speaking
• » More

• Issue dates
• Regions
• Health plans
• Sections
• News briefs
• Columns
• Editorials
• Letters
• Writers
• Other years

• Search tips
• E-mail alert
• Radio
• RSS
• Mobile
• Subscribe
• Institutions
• Staff directory
• Advertising
• Permissions
• Reprints
• News media
• Site guide
• Useful links
• About
• Premium
• Contact

Mandatory in-hospital referrals banned

Texas becomes the second state to pass such a law as the trend continues toward employing a growing number of hospitalists.

By Cheryl Jackson, amednews staff. June 25, 2001.

• PRINT|
• E-MAIL|
• RESPOND|
• REPRINTS|
• SHARE

Even as the use of hospitalists grows, states are moving to make sure it does so only with the consent of primary care physicians involved.

The Texas Legislature last month passed a bill that prohibits health plans from requiring referrals to hospitalists. If the governor signs it, as expected, Texas will join Florida in having bans on the books. Florida's ban was passed last year.

Proponents of the bans say such laws are necessary as more health plans want to impose their hospitalist programs on primary care physicians, who are worried about losing their patients.

About 5,000 hospitalists practice in the United States, up from about 400 in 1995, according to the National Assn. of Inpatient Physicians.

But others say there's no need for actual legislative action because plans that consider mandatory programs typically quickly back down after physicians get up in arms.

"For the most part, the marketplace will take care of those mandatory referrals," said John Nelson, MD, a founder of the NAIP. The hospitalists group opposes the mandatory referrals to hospitalists.

"I don't want health plans or other people interfering with the choices patients and doctors should be able to make for themselves," said Dr. Nelson, a hospitalist in Bellevue, Wash.

Still, he said, it's uncommon for health plans to force primary care physicians to refer patients to hospitalists. Mandatory programs account for 2% of hospitalists arrangements in the country, according to a 2000 survey of internists. [...]