MASSACHUSETTS: House Speaker Unveils HMO Reform Package
House Speaker Thomas Finneran (D) yesterday outlined the key provisions "of a sweeping proposal to regulate" HMOs in Massachusetts, the Boston Globe reports. In a two-page memo, Finneran "said the bill is likely to contain key provisions to protect patients," and said that "a meaningful, comprehensive, and prudent managed care bill can pass the House in a timely fashion." The memo was co-signed by the chairs of the Health Care, Insurance and Ways and Means committees; the bill is now in the House Ways and Means Committee. Finneran said the bill will likely include the following provisions: "[s]tronger provisions for patients to appeal HMO denials of coverage; [c]learer standards for coverage of emergency room visits; [d]isclosure of physician pay and financial incentives"; a requirement for HMO report cards; "[a]doption of national accreditation standards for measuring an HMO's quality"; and a "mechanism to incorporate self-funded health plans in state regulation."
The Coalition for Managed Care Quality was quick to question the package. In a "strongly-worded" statement, the patient advocate-provider coalition said: "If the bill is confined to the points noted in the letter, it is unlikely to provide meaningful and positive changes for the people of Massachusetts." The coalition noted several missing protection: "access to specialty physicians, a consumer assistance program, the creation of an independent state office to oversee HMOs, [and] limits on financial incentives to physicians." Senate Health Care Committee Chair Mark Montigny (D) vowed to hold up the bill if it "isn't meaningful reform" (Pham, 7/23).