CALIFORNIA: MANAGED CARE REFORM PACKAGE TO BE INTRODUCED

      "Continuing the push for stricter regulation of the managed
 care industry, a group of Democratic lawmakers, health care
 advocates and labor unions" yesterday unveiled a package of
 consumer protection reforms.  LOS ANGELES TIMES reports that the
 package of 11 bills, the Patient Bill of Rights, "revisits"
 issues addressed last fall in two failed ballot measures (see AHL
 9/13/96).  The bills include a proposal, introduced by state Rep.
 Michael Sweeney (D), to require health insurers to pay for a
 second opinion from a qualified physician upon the request of a
 patient.  Two bills sponsored by state Reps. Liz Figueroa (D) and
 Valerie Brown (D) "would require insurers to pay for a minimum
 48-hour hospital stay and postsurgical home visits for patients
 undergoing mastectomies, lumpectomies and other breast cancer
 surgery" (Olmos, 2/26).  Another bill that would "forbid HMOs
 from firing doctors without prior notice and a written reason,"
 as well as "tighten oversight of HMOs providing coverage to
 recipients of Medi-Cal" was introduced by House Health Committee
 Chair Martin Gallegos (D).  Figueroa and Gallegos are also co-
 sponsoring a bill that would require "HMOs to publish their
 criteria for denying medical care," SAN FRANCISCO CHRONICLE
 reports.  The measure would require "that the person denying care
 must be a doctor licensed to practice in California" (Russell,
 2/26).
      THE ROSTER:  Specific legislation in the package includes; 
 patient protection, termination without cause (AB 434); public
 disclosure and liability for denial of care (AB 536); timely
 access to health care (AB 497); guaranteed second opinion (AB
 341); timely treatment, HMO liability for denial of care (SB
 324); safe care, hospital discharges (AB 269); whistleblower
 protections (SB 253); Medi-Cal managed care enrollment
 protections (AB 426); same-day mastectomies (AB 12, AB 7); drive-
 through deliveries (AB 38); and free speech rights for HMO
 consumers (Health Access California release, 2/26).
      TRY, TRY AGAIN:  TIMES reports that the bill sponsors "say
 they hope to accomplish in the Legislature what they were unable
 to achieve by direct vote" (2/26).  "Backers are convinced that,
 despite defeat of HMO reform efforts at the polls, there is still
 strong public support for measures that check the growing power
 of health insurers over medical decision-making," CHRONICLE
 reports.  Figueroa said, "We're trying to accomplish what the
 initiative process failed to do in November:  restore quality of
 care to health care in California" (2/26).  TIMES reports that
 "California legislators and HMO industry officials say they
 anticipate more than 100 managed care bills to be put up for
 consideration this year" (2/26).