You asked for information on a recent California proposal concerning preventive health screening by HMOs.

Under regulations proposed June 19, 2002, the California Department of Managed Health Care (DMHC) would require the state's HMOs to develop preventive health strategies in three areas: smoking cessation, chlamydia testing, and colorectal screening. California currently has a "loose mandate" requiring HMOs to provide preventive health services. The proposed regulations require the HMOs to submit information outlining their prevention activities in the three areas, with a follow-up report a year later. DMHC decided to focus on these three areas because the agency believed they need the most improvement and would cost the least to implement.

The federal Centers for Disease Control and Prevention (CDC) estimated in 1997 that chlamydia screenings could be conducted in California for about $ 26 million, resulting in a $ 300 million savings to insurers, the government, and individuals for treating this sexually transmitted disease (see "State Asks HMOs for Screenings, San Francisco Chronicle, June 20, 2002).

Less than a third of California HMO enrollees with job-based insurance have smoking cessation as a covered benefit, fewer than one in five sexually active women between ages 16 and 26 were tested for chlamydia in the course of a year, and less than half of adults over age 50 were screened for colorectal cancer over the last five years (see NCSL's State Health Notes, July 15, 2002, p. 3).

JK: ro