Managed Care: Explicit Gag Clauses Not Found in HMO Contracts, But Physician Concerns Remain

Pursuant to a congressional request, GAO reviewed contractual limitations, known as gag clauses, imposed by health maintenance organizations (HMO), that interfere with the physician-patient relationship by impeding discussions of treatment options, focusing on: (1) the types of contract clauses that could impede a physician's ability to advise patients of all medically appropriate treatment options; (2) the extent to which these different types of clauses exist in current HMO contracts with physicians; and (3) the likely implications of HMO contract language on physician practice.