ATLANTA – Overall, things are better at the Dalton pedi-atric practice of Dr. Martin Michaels in recent months, after a rough period when Medicaid patients moved to HMO-like organizations in 2006.

"The transition was rocky," Michaels said. "But a lot of it has smoothed out from that standpoint."

But Michaels, president of the Georgia Chapter of the American Academy of Pediatrics, also understands that his experience isn't the same as everyone else's.

Some providers of health care, including specialists and hospitals, have struggled to square away financial argu-ments with the "care management organizations," or CMOs, that now handle most of the taxpayer-funded health care for low- and middle-income Georgians, he said.

"Some people seem to have more trouble with that than others," Michaels noted.

Frustrations from those who are having more trouble has lead to a push at the Georgia General Assembly from law-makers such Rep. Mickey Channell, R-Greensboro, to try to put new regulations and restrictions on the CMOs.

Channell has sponsored a comprehensive measure, House Bill 1234, aimed at correcting a laundry list of problems the health-care community has complained about for months.

"Most of what's in this bill attempts to deal with the prob-lems that we've heard from all providers," Channell said.

For example, Channell's measure would require CMOs to pay interest on any claim they improperly deny; give doc-tors and hospitals new tools when appealing denials; and set out clearer standards on other financial disagreements.

One portion of the bill would limit when a CMO could pay a $50 "triage fee" for an improper emergency room visit instead of the full cost of treatment. Channell said one of the three CMOs has paid the triage fees in about 80 percent of cases, only to have a majority of those decisions over-turned in the CMO's own appeals process.

"One could surmise that that's a deliberate attempt to delay the payment process," Channell said. "If it's an emergency, it ought to be paid as such."

Channell's bill would also require the state Department of Community Health, which oversees Medicaid and Peach-Care, to pay for treatment given to any patient mistakenly listed as having coverage on the agency's Web site. CMOs have been reclaiming errant payments from doctors, who have only the department's Web site to go by.

"They're the ones that made the error, not the provider," Channell said. "That's the bottom line."

The CMOs, which have been hammered for months by doctors and patients complaining of bureaucratic hiccups, have shied away from taking a stance on Channell's bill, which could be approved by a House subcommittee as soon as today.

"Our policy is to not comment directly on pending legisla-tion," John Aberg, a spokesman for WellCare Health Plans, said in an e-mail. "As part of our ongoing relationship with the State of Georgia, we will continue to work with all parties to ensure that Medicaid and PeachCare members have increased access to quality care."

Brandon Larrabee can be reached at bran-don.larrabee@morris.com or (678) 977-3709.