From Miami Bureau Chief John Zarrella

MIAMI (CNN) -- When Katyna Lopez was told her primary care physician couldn't see her for a couple of days, she decided not to wait. Instead, she came to Baptist Hospital -- and her HMO will have to pay for the visit.

"It's wonderful to know I can just walk in here and I get great help," Lopez said. "Great service and then I can go home."

In Florida, new laws have given health maintenance organization subscribers increased access to care. Besides the emergency room, there's direct access to dermatologists.

Doctors are no longer prohibited from telling patients about expensive treatments.

It's consumer protection, but at what price?

Baptist Hospital's emergency room, for example, expects to see an increase of 7,000 to 10,000 patients this year.

"When a person, a reasonable person has symptoms, then I think the patient needs to be seen in a reasonable amount of time and the only option they have is an emergency department," said Baptist Hospital's Dr. David Nateman. "So I can see where they are coming from."

But AvMed, one of the largest HMOs in Florida, has seen its emergency room costs go up an average of $9 per member. Dermatology costs are up nearly 40 percent.

"We don't print money," said Dr. James Moffat, vice president of AvMed Health Plan. "The only source that we have is premium dollars that we get.

"Our premiums will be going up next year. Bet on that one. They are going up because our medical costs are going up."

Florida, which has more HMO subscribers than any state, is also the first with an appeals board. HMOs can be fined up to a quarter of a million dollars for denial of covered services.

"If you have a big stick at the end, our subscriber assistance panel, our grievance panel, if you have that big stick at then end, it turns out that you solve 90 percent of the problems in the beginning," said Douglas Cook, Director of the Florida Agency for Health Care Administration.

In five years, the six-member panel has heard only 52 cases. But 65 percent were decided in the consumers' favor.

HMOs contend that because only one panel member is a doctor, the board decisions are not based on sound medical judgments.

"The issue that we have is... that decision should be made by health care professionals who are looking at the health care needs and requirements of that patient," said Moffat. "It should not be politicized."