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Obama Administration Scraps the “Medical Mystery Shopper” Program

by Leah Greene, JD, LLM on June 29th, 2011

Today, the U.S. Department of Health and Human Services (“HHS”) announced it will halt its plan to have “medical mystery shoppers” contact primary care physicians to determine whether they accept or reject new patients based on the type of insurance they have.

Yesterday, the New York Times reported that the Obama administration intended to recruit “medical mystery shoppers” who would pose as patients attempting to schedule an appointment with primary care physicians. The program’s goal was to ascertain whether primary care physicians were accepting patients with private insurance and/or rejecting patients enrolled in government health plans that reimbursed physicians at a lower rate. The plan involved contacting over 4,000 physicians in nine states. The mystery shopper would call twice – once posing as a private insurance patient and another time as a patient enrolled in a public health plan.

The American Medical Association strongly opposed this proposal, explaining it would only worsen the current physician shortage. Physicians interviewed for The New York Times article expressed resentment at what appeared to be a “Big Brother” effort by the government.

Instead of the “mystery shopper” program, the HHS will focus on ways to improve access to primary care physicians, such as training new physicians and encouraging them to provide services in underserved areas. The Obama Administration also stated it will work towards increasing payments to providers.

More information regarding the mystery shopper plan is found here.

Information regarding the announcement to halt the mystery shopper plan is found here.

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From → Health Law