MANAGED CARE REFORM PLAN

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Adding to more than a dozen existing legislative propositions on managed care regulation, Rep. Nydia Velazquez (D-Brooklyn/Manhattan) announced her own bill last week, which will join the jumble of proposals slouching toward Congress from both parties and from HMOs themselves.

Velazquez’s Managed Care Bill of Rights would guarantee patients access to bilingual services, second opinions, coverage for emergency care and specialized treatment. “We want to ensure that patients from low-income areas will have access to the same quality care that everyone else does,” Velazquez said Monday at a Manhattan press conference.

John Mills, director of federal legislation for HIP, a major New York HMO, was also on hand, and although he didn’t specifically back Velazquez’s bill, he said such national standards will be a critical step toward restoring consumer trust. HIP, two other HMOs, the American Association for Retired Persons, and Families USA, a national health consumer group, have released an independent statement called the “Principles for Consumer Protection”–some elements of which are included in Velazquez’s bill.

Critics maintain, however, that while Velazquez’s proposal is a step in the right direction, it doesn’t go far enough. “There’s no provision for external review [for patient grievances],” said Legal Aid Society attorney Elisabeth Benjamin. “Without that, [your HMO] is the judge, jury and executioner.”

Among the several managed-care regulation bills under congressional consideration, observers on the Hill report that a Republican bill sponsored by Rep. Charles Norwood (R-Georgia) and Sen. Alfonse D’Amato is leading the pack, along with its Democratic counterpart, a proposal co-sponsored by Ted Kennedy and Rep. John Dingell (D-Mich.). A vote on the issue is not likely until spring.