CIS/Index
Copyright © 1999, Congressional Information
Service, Inc.
99 CIS H 27190
TITLE: America's
Health: Protecting Patients' Access to Quality Care and Information
CIS-NO: 99-H271-90
SOURCE: Committee on
Commerce. House
DOC-TYPE: Hearing Retrieve
the full text of testimony
DATE: Mar. 24, June 16, 23, 1999
LENGTH: iii+352 p.
CONG-SESS: 106-1
ITEM-NO:
1019-A-01; 1019-B-01
SUDOC: Y4.C73/8:106-48
SUMMARY:
Committee Serial No. 106-48. Hearings
before the Subcom on Health and Environment to examine issues related to health
care quality and health insurance plan patient protection, focusing on managed
care plans.
Also briefly considers H.R. 358 and S. 6, both the
Patients' Bill of Rights Act of 1999, to prohibit group health plans and health
insurance companies from arbitrarily interfering with or altering the manner or
setting in which care is delivered if that care is medically necessary or
appropriate, and to define medical necessity as care consistent with the
generally-accepted standards of professional medical practice.
Supplementary material (p. 176-186 and throughout) includes correspondence,
submitted statements, an article, and:
-- Henry J. Kaiser
Family Foundation; and Commonwealth Fund, "Working Families at Risk: Coverage,
Access, Costs, and Worries" excerpts, Apr. 1998 (p. 176-181).
CONTENT-NOTATION: Managed health care quality and
consumer protection, review
BILLS: 106
H.R. 358; 106
S. 6
DESCRIPTORS:
SUBCOM ON HEALTH AND ENVIRONMENT. HOUSE; MANAGED
HEALTH CARE; HEALTH FACILITIES AND SERVICES; HEALTH INSURANCE; CONSUMER
PROTECTION; PATIENTS' BILL OF RIGHTS ACT; MEDICAL REGULATION; PHYSICIANS;
MEDICAL ETHICS; COMMONWEALTH FUND; FAMILIES; MEDICAL ECONOMICS
99-H271-90 TESTIMONY NO: 1 Mar. 24, 1999 p. 19-67
WITNESSES (and witness notations):
AUER,
NANCY J. (Dr.) (Medical Director, Emergency Services, Swedish Medical Center,
Seattle, Wash.; representing American College of Emergency Physicians)
BRAUN, JOSEPH (Dr.) (Chief Medical Officer, George
Washington University Health Plan; representing American Association of Health
Plans)
THOMAS, PETER W. (former Chair, Subcom on Consumer
Rights, Protections, and Responsibilities, President's Advisory Commission on
Consumer Protection and Quality in the Health Care Industry)
STATEMENTS AND DISCUSSION:
Need to establish Federal
consumer protection standards applicable to all health plans; overview of health
plan industry efforts to improve patient health care quality; perspectives on
health care quality issues and consumer protection standards.
CONTENT NOTATION:
Managed health care quality and
consumer protection, review
TESTIMONY DESCRIPTORS:
AMERICAN COLLEGE OF EMERGENCY PHYSICIANS
99-H271-90 TESTIMONY NO: 2 Mar. 24, 1999 p.
67-107
WITNESSES (and witness notations):
REARDON, THOMAS R. (Dr.) (President-Elect, AMA)
LEHNHARD, MARY N. (Senior Vice President, Blue Cross and
Blue Shield Association)
POLLACK, RONALD F. (Executive
Director, Families USA Foundation)
STATEMENTS AND DISCUSSION:
Need for patient protection legislation that would require
health plans to provide enrollees with essential plan information and prevent
plans from improperly interfering with patient-physician communications;
opposition to proposals to require collection and reporting of medical outcomes
data.
Support for S. 6 and H.R. 358, citing need for
consumer protections; elaboration on issues related to health plan patient
protection legislation.
CONTENT NOTATION:
Managed health care quality and consumer protection,
review
TESTIMONY DESCRIPTORS:
AMERICAN
MEDICAL ASSOCIATION; INFORMATION SERVICES AND SYSTEMS; PHYSICIANS; MEDICAL
REGULATION
99-H271-90 TESTIMONY NO: 3
June 16, 1999 p. 130-175
WITNESSES (and
witness notations):
HORSLEY, MARY (consumer)
ARNETT, GRACE-MARIE (President, Galen Institute)
NEESE, S. THERESA (Past President and Public Policy
Advisor, National Association of Women Business Owners)
GARCIA DE POSADA, ROBERT (Executive Director, Hispanic
Business Roundtable)
ROWLAND, DIANE (Executive Vice
President, Henry J. Kaiser Family Foundation)
STATEMENTS AND
DISCUSSION:
Concerns regarding impact of health insurance
regulation on insurance costs and growth in number of uninsured; recommendations
regarding measures to extend health insurance coverage to uninsured population
(related graphs, p. 148-155); issues related to health insurance access for the
uninsured.
CONTENT NOTATION:
Managed health
care quality and consumer protection, review
TESTIMONY
DESCRIPTORS:
KAISER, HENRY J., FAMILY FOUNDATION; MEDICAL
REGULATION; STATISTICAL DATA: HEALTH AND VITAL STATISTICS
99-H271-90 TESTIMONY NO: 4 June 16, 1999 p. 187-235
WITNESSES (and witness notations):
JOHNSON,
DANIEL H., JR. (Dr.) (President, World Medical Association)
ARTH, RAYMOND (President, Phoenix Products; representing
Council of Smaller Enterprises)
MOREHEAD, ROBERT N. (Area
President, Gallagher Byerly, Inc)
MEYER, JACK A.
(President, Economic and Social Research Institute)
BAUMGARDNER, CHRISTINE (Executive Director, Alcona Health
Center, Lincoln, Mich)
CARLSON, RICHARD W. (Executive
Director, Illinois Comprehensive Health Insurance Plan)
NICHOLS, LEN M. (Principal Research Associate, Urban
Institute)
STATEMENTS AND DISCUSSION:
Perspectives on proposals to expand health insurance
coverage for the uninsured, including use of health insurance purchasing
cooperatives; experience of Illinois with use of State risk pool, known as the
comprehensive health insurance plan, to comply with requirements of Health
Insurance Portability and Accountability Act.
Findings of
research study employing models to assess consequences of employers using
different approaches to providing employee health insurance coverage; views on
various approaches to expanding health insurance coverage for the uninsured.
CONTENT NOTATION:
Managed health care
quality and consumer protection, review
TESTIMONY DESCRIPTORS:
COUNCIL OF SMALLER ENTERPRISES; STATE GOVERNMENTS;
ECONOMIC AND ECONOMETRIC MODELS; COOPERATIVES; ILLINOIS; HEALTH INSURANCE
PORTABILITY AND ACCOUNTABILITY ACT
99-H271-90
TESTIMONY NO: 5 June 23, 1999 p. 267-312
WITNESSES (and witness notations):
CONWAY, WILLIAM A.
(Dr.) (Vice Chair, Henry Ford Medical Group; representing American Medical Group
Association)
BARRON, CONNIE (Associate Director,
Legislative Affairs, Texas Medical Association)
WEISS,
BRUCE A. (Dr.) (Group Vice President, Medical Operations, AvMed Health Plan)
GROGG, STANLEY E. (Dr.) (Associate Professor, Pediatrics,
College of Osteopathic Medicine, Oklahoma State University; representing
American Osteopathic Association and American College of Osteopathic
Pediatricians)
STATEMENTS AND DISCUSSION:
Concerns regarding proposals to expand health plans
liability, citing benefits of grievance and appeals processes; positive
experience of Texas with managed care plan reform; description of State
grievance procedure requirements affecting AvMed and other health plans in
Florida.
Problems of children enrolled in managed care
plans regarding access to appropriate treatments and facilities; elaboration on
managed care reform issues.
CONTENT NOTATION:
Managed health care quality and consumer protection,
review
TESTIMONY DESCRIPTORS:
AMERICAN
MEDICAL GROUP ASSOCIATION; APPELLATE PROCEDURE; STATE GOVERNMENTS; PEDIATRICS;
LIABILITY; TEXAS; FLORIDA
99-H271-90 TESTIMONY NO: 6
June 23, 1999 p. 313-352
WITNESSES (and
witness notations):
ATKINS, G. LAWRENCE (President, Health
Policy Analysts; representing Corporate Health Care Coalition)
ROSENBAUM, SARA (Professor, Health Law, George Washington
University)
DUNNE, PHILIP K. (CEO, Texas Medical
Foundation)
STATEMENTS AND DISCUSSION:
Benefits of independent, external review of health plan
medical treatment questions to ensure accountability for health care decisions;
review of key elements of external review process regarding health plan medical
treatment decisions; elaboration on external review of health care decisions and
related issues.
CONTENT NOTATION:
Managed
health care quality and consumer protection, review
TESTIMONY
DESCRIPTORS:
CORPORATE HEALTH CARE COALITION
