MANAGED CARE REFORM: Assembly Puts Bill On Wilson’s Desk
The state Assembly yesterday sent a bill to Gov. Pete Wilson that would "make it easier for patients to compare benefits among various health plans," the Los Angeles Times reports. Aides to the governor indicated Wilson "would sign it into law." Sponsored by Assemblyman Jack Scott (D-Altadena), AB 607 "would require HMOs to draft in simple terms the major components of the benefits they offer patients." It would also require all HMOs operating in the state to "use uniform formats for easy comparison." Scott's measure passed the Assembly 60-0 yesterday after previously clearing the Senate.
Only The Beginning
The Times reports that Scott's bill is "the first of what could be dozens of bills to change managed care practices." Assembly Health Committee Chair Martin Gallegos (D-Baldwin Park) said AB 607 "and others to follow in coming weeks represent only modest reform of regulations governing" HMOs. Two other incremental bills "are expected to receive final passage and head to Wilson as early as next week." The first, which was approved by the Senate last week, "would allow women to bypass primary care doctors ... and make appointments directly with" OB/GYNs (see CHL 3/20). The other "would guarantee patients a second opinion on a diagnosis in some cases, including when surgery is recommended."
But the Times reports that "bills much tougher on HMOs lie ahead, setting up a possible confrontation between Democrats and Wilson." These proposals include allowing "patients to sue managed care plans for malpractice for the first time in California" and requiring HMO medical directors to be licensed in California. Another controversial measure is Wilson's plan to bring all managed care oversight under one state administrative agency "with one director as the chief regulator." According to the Times, "Democrats maintain that a panel of commissioners who are not solely appointees of the governor should wield that power." Now, however, "all sides in the Legislature expressed optimism that 1998 would be a record year for placing new controls on HMOs." Lisa Kalustian, spokesperson for the governor, said, "We are very hopeful we'll be able to accomplish the principles the governor has laid out and continue to work with the Legislature" (Vanzi, 3/27).