I am a practicing specialist physician in California.  Internally, the
empahsis in my HMO is on two week access for patients who get referred
to specialist care, and we do usually provide that.  I believe the
primary incentive to providing two week initial access to specialists
is based on a marketing strategy, but also on being in compliance with
federal guidelines for medicare
patients.  Unfortunately, the HMO turns a blind eye to the need for
timely follow up visits that may be required to provide adequate pain
relief.
Sometimes patients have to wait more than eight to 12 weeks to see me in
follow up visits, because there are not enough MD's in the clinic to
accomodate the demand.  I believe this is unacceptable, but have not
been able to force the HMO to provide more staffing.  My HMO has been
slow to respond to my advocacy for the patients rights to timely
followup care.  
QUESTION:  Are there federally or state mandated standards that I
can use to make my case that we are
out of compliance?  
The threat of loss of medicare reimbursement would
seem to provide the leverage needed to force the HMO to staff
appropriately so that patients do not have to wait 2-3 months for
their next visit.  Thank you.