Lawmakers to Seek Changes in Managed Care Health Plans

Article excerpt

Improving managed health care for Missourians is among state Sen. Joe Maxwell's top priorities for next year's session. He hopes to avoid pitfalls that gave Gov. Mel Carnahan a crushing legislative defeat in the health care arena.

Maxwell, D-Mexico, was co-chairman of a House-Senate committee studying the complicated field of managed care. After hearing from scores of witnesses, the panel came up with 33 ideas that will be the basis for bills during the session that begins Jan. 8.

The last time health care was a major legislative topic was 1994, when Carnahan tried to change the law to make health insurance more affordable and available. It was defeated by an intense lobbying effort that left the governor angry and frustrated. "We have not tried to make any sweeping changes in the delivery system. Our plan is more moderate and more reasonable," Maxwell said. Managed care interests provide some sort of package to more than 2 million Missourians. Most forms of managed care rely on the use of spec ific physicians, hospitals and health care providers who have contracts with the patient's health insurance company. "People are concerned that government will step in and make it too costly or take something away from them," Maxwell said. "We, as legis lators, must make sure that we don't harm the current system." Rep. Tim Harlan, Maxwell's co-chairman, said he was optimistic that legislation developed from the fall hearings has a chance of passage. "If there was ever a time that the insurance lobby can be overcome, this is it, because the problems with managed care affect all our constituents," said Harlan, D-Columbia. Key committee recommendations include basing the definition of a medical emergency on what a "prudent layperson" would consider it to be, plus settling disputes by binding arbitration before an independent panel. …