Auditor: Minnesota needs better HMO complaint system

Minnesota's legislative auditor says the process for filing quality of care complaints against HMOs is confusing and lacks transparency.

HMO enrollees have few options for a thorough review of their complaints about substandard health care, and the Minnesota Department of Health's power to investigate some HMO complaints is too limited, the auditor's office said in a report published Friday.

Patients have complained that they don't get an adequate response from the department after filing an HMO complaint, Legislative Auditor Jim Nobles said.

"People can always bring a lawsuit, but that's very expensive," Nobles said. "State government is here to help people, so that shouldn't necessarily be something that they have to resort to."

Nobles says the health agency should be the first place of contact for complaints about bad care.

The Health Department said it agreed with the auditor's recommendations and will improve its process for reviewing and receiving HMO complaints, but that it may require lawmakers to simplify complaint statutes.