CALIFORNIA: MANAGED CARE REFORM PACKAGE TO BE INTRODUCED
"Continuing the push for stricter regulation of the managedThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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,
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).