SPECIALIST ACCESS: Assembly Passes Bill To Provide ‘Standing Referrals’
Under a bill passed by the state Assembly yesterday, chronically ill or disabled patients who frequently need to see a specialist will no longer need to obtain repeated referrals from their primary doctor. The Sacramento Bee reports the bill (AB 1181), sponsored by state Assemblywoman Martha Escutia (D-Huntington Park), was sent to Gov. Pete Wilson, who is expected to sign it. A Wilson spokesperson said Escutia "worked with the administration to address" the governor's concerns about the measure. Escutia said her bill will ensure "timely access" (4/24). Under the bill, every health plan in the state would be required to establish a procedure under which an enrollee could receive a standing referral to a specialist if their primary care physician determined it was necessary. In addition, every health plan would have to establish a procedure under which enrollees with life-threatening or debilitating illnesses could switch their primary care physician from a general practitioner to a specialist. Finally, the bill would require that referrals be made within seven business days of a request. "We all understand that health care is a business. The important thing, however, is to remember that patients have to come before profits," said Escutia at yesterday's capitol press conference. "This legislation is pro-consumer, not anti-managed care," she said, adding that her bill is "a tough, but needed step" to help protect patients from "the red tape that can derail their care."
Escutia's bill mirrors a recommendation made by Wilson's managed care reform task force and has the "support of state and national health advocates," including the National Cystic Fibrosis Foundation, AIDS Project Los Angeles, the American Lung Association, the California Association of Health Plans, Consumers Union, the Hemophilia Council of California and the National Multiple Sclerosis Society, Protection and Advocacy Inc. (release, 4/23).