Acting Gov. Paul Cellucci has offered an HMO regulation proposal he says will cover more people in Massachusetts than another bill under consideration.
Cellucci’s bill would require HMOs to be accredited by the Department of Public Health. Plans would have to cover emergency services in situations that a “prudent lay person” would consider an emergency. The measure would also force plans to disclose physician compensation and set up procedures to resolve grievances and payment disputes. Plans would be barred from putting doctors at financial risk for the cost of treatments. The state would establish a managed care ombudsman to help people exercise their rights.
Cellucci says his bill would cover 700,000 more people than a plan crafted by the House committees on health care and insurance, because his proposal includes plans that contract with self-insured employers. The governor expressed willingness to craft a consensus bill that combines the two proposals. Legislative action is expected this month.
Our most popular topics on Managedcaremag.com
Paul Lendner ist ein praktizierender Experte im Bereich Gesundheit, Medizin und Fitness. Er schreibt bereits seit über 5 Jahren für das Managed Care Mag. Mit seinen Artikeln, die einen einzigartigen Expertenstatus nachweisen, liefert er unseren Lesern nicht nur Mehrwert, sondern auch Hilfestellung bei ihren Problemen.