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