Davis Approves Four Bills To Bolster State Oversight of HMOs
Gov. Gray Davis (D) on Sunday signed four bills to strengthen state HMO regulations enacted earlier in his administration, the Los Angeles Times reports (Gottlieb, Los Angeles Times, 9/23). Summaries of the bills appear below.
SB 842: The bill, sponsored by Sen. Jackie Speier (D-Hillsborough), allows the Department of Managed Health Care to require HMOs to cover certain treatments for patients with cancer, AIDS, heart disease and other illnesses (Talev, Sacramento Bee, 9/23). DMHC Director Daniel Zingale said that without the legislation, HMOs could deny access to "life-saving drugs."
AB 1401: The bill, sponsored by Assembly member Helen Thomson (D-Vacaville), allows 4,000 individuals denied coverage through the state's Managed Risk Medical Insurance Program, which provides coverage to those considered uninsurable in the private insurance market, to enroll in a four-year state pilot program (Coleman, AP/Contra Costa Times, 9/23). The pilot program, scheduled to begin in September 2003, would extend COBRA coverage to unemployed workers for 36 months, would limit enrollment in the state's "major risk programs" to 36 months and would require health insurers to offer "reasonably affordable coverage" to uninsurable residents. The state and insurers would share the cost of premiums.
AB 2179: The bill, sponsored by Assembly member Rebecca Cohn (D-Saratoga), requires the DMHC by January 2004 to draft standards for "reasonable lengths of time" that patients can wait for appointments with primary care providers and specialists or for emergency care (Sacramento Bee, 9/23). After the department establishes the guidelines, HMOs and state regulators will determine the cause of delays in care (AP/Contra Costa Times, 9/23). The legislation also allows the DMHC to oversee the quality of care that HMOs provide, not only their finances (Los Angeles Times, 9/23). "A lack of timeliness can be an indication of other systemic problems, like a lack of doctors, or the financial solvency of an organization," Cohn said (AP/Contra Costa Times, 9/23).
- AB 2085: The bill, sponsored by Assembly member Ellen Corbett (D-San Leandro), allows patients to file complaints with an HMO over the Internet (Sacramento Bee, 9/23). HMOs must resolve the complaints within 30 days (AP/Contra Costa Times, 9/23).