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More than half of all direct-pay health care providers in New York aren’t complying with the Managed Care Consumer Bill of Rights, according to a study released by Attorney General Eliot Spitzer Tuesday. Passed in 1996, it requires companies to provide detailed information about the care their plan provides, so potential buyers can tell if the plan will cover services they might need. But Spitzer’s report card found that buyers are being left in the dark. Even with what he called “grade inflation in the worst way,” seven plans received a D grade, and 11 failed. The study was conducted by members of the Attorney General’s staff who posed as prospective HMO clients with various needs (breast reduction surgery, arthroscopic knee surgery, etc.), using their own names and addresses to request the information. Just 15 percent of the letters received detailed responses as required by the law; the rest garnered only vague pamphlets—or no response at all. According to Assistant Attorney General Paul Beyer, the Attorney General’s office expects to improve compliance in three to four months without fining the companies.[04/05/04]

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