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The much-hated gag rules are officially out at least from health plans that contract for Medicare members with the Health Care Financing Administration (HCFA).
The U.S. Department of Health and Human Services has notified more than 300 managed care organizations (MCOs) that contract for Medicare coverage that they cannot prevent physicians from providing information to patients regarding medically necessary treatment options.
"No beneficiary should be denied the information they need to make a sound, informed decision on their treatment," said department Secretary Donna E. Shalala. "Patients and their doctors must have a free exchange of information."
Physicians and health care organizations raised a firestorm of protest beginning early last year over clauses they said some MCOs were inserting in the contract prohibiting doctors from discussing treatment options that were not available through that insurer. As opposition to the clauses expanded, a number of states enacted laws prohibiting them.
The federal ruling applies immediately to 4.7 million Medicare beneficiaries enrolled in managed care plans. In addition, HCFA says it is developing a similar policy for Medicaid recipients.