Copyright 1999 The Baltimore Sun Company
THE
BALTIMORE SUN
February 4, 1999, Thursday ,FINAL
SECTION: BUSINESS ,3C
LENGTH: 563 words
HEADLINE:
Patient's Bill of Rights' gets mixed reaction in hearing;
Doctors, providers hail it; insurers warn of costs
BYLINE: SUN STAFF
BODY:
Doctors, consumer advocates and a bevy of health care providers hailed the
"Patient's Bill of Rights" during a legislative hearing in
Annapolis yesterday, while insurers and the business community warned that
mandating drugs, specialists and hospital stays could drive costs higher.
The bill, one of Gov. Parris N. Glendening's legislative priorities,
"would clearly establish Maryland as a national leader in protecting its
citizens from managed-care company abuses," Joan Alker of the Families USA
Foundation, a Washington consumer group, told the Senate Finance Committee.
Supporters said the measure would bolster an already strong set of state
laws and regulations designed to ride herd on health insurers, including a new
procedure for reviewing patient complaints about denial of treatment.
"The governor believes we can do more to make sure Maryland patients
have access to the care they need," said Abby Brandel, an administration
lobbyist.
The bill would require insurers, nonprofit health plans and
health maintenance organizations to offer patients:
Standing referrals
to specialists for life- threatening, chronic or disabling diseases.
Access to specialists outside their health plan when the in-house
doctors lack expertise in a patient's illness.
Access to prescription
drugs not covered by their plan if deemed medically necessary and all other
approved medicines have been ineffective or caused adverse side effects.
Minimum hospital stays of 48 hours for a mastectomy or testicular cancer
surgery.
The bill also would allow specialists to serve as a patient's
"primary care coordinator" when overseeing treatment of a chronic or serious
disease, and it would establish the Maryland Insurance Administration as the
state clearinghouse on health insurance information.
Insurance
Commissioner Steven B. Larsen called the bill's provisions "fair" and "common
sense," adding that even he could use help at times dealing with his health
plan.
"I'm the insurance commissioner, and I still run into static when
I try to get care for my family," he said.
The Medical and Chirurgical
Faculty of Maryland, the state's medical society, urged lawmakers to extend the
rights to low-income patients in Medicaid managed-care plans, but questioned the
mandated hospital stays.
" Protect the doctor to help and advocate for
the patient," said Joseph A. Schwartz III, Med-Chi's lobbyist, "but don't make
every patient stay in for 48 hours."
Psychologists, chiropractors,
nurses and midwives, meanwhile, urged that the bill be broadened to let them be
considered as specialists coordinating patient care.
Lobbyists for HMOs
and other health plans contended that they already give patients standing
referrals and access to unapproved drugs and outside specialists, though they
usually charge a higher co-pay. They urged lawmakers not to interfere with that
practice.
"We're clearly concerned about escalating drug costs," said
Pegeen Townsend, a lobbyist for the Maryland Hospital Association.
She
attributed 25 percent increases in prescription costs to drug company
advertising urging patients to ask for costlier brand-name medications.
State fiscal analysts noted that requiring health plans to pay for drugs
not on their approved lists could add $775,000 next year to the
cost of the State Employees Health Benefits Plan.
LOAD-DATE: February 5, 1999
