MANAGED CARE: States Passed Numerous Bills in 1999
More than 50 new state laws regarding managed care health plans were passed last year, according to a new study released yesterday by the Blue Cross-Blue Shield Association. Three states -- California, Georgia and Louisiana -- joined Texas in expanding a patient's right to sue their health plans for damages from denial of care. And, an additional 14 states established or broadened external review procedures as an alternative to allowing patients to sue their health plans. Requiring plans to pay for care deemed "medically necessary" by physicians also was a hot topic last year as one third of state legislatures considered such bills. Three states -- Georgia, Minnesota and Montana -- enacted the measures while Vermont adopted a similar requirement by regulation. Nine states passed laws that allow certain patients to continue to see their physicians even after those providers have left their health plans and 10 states passed laws providing patients easier access to prescription drugs not on their plans' formularies. Five states passed laws requiring health plans to cover clinical trials of experimental drugs, and a number of state legislatures passed laws to expand coverage to the uninsured, particularly children through the Children's Health Insurance Program (Rovner/Wegner, CongressDaily, 2/15).
This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.