Newspaper article THE JOURNAL RECORD

Nickles' Role in Health Care Legislation Predicted to Increase

Newspaper article THE JOURNAL RECORD

Nickles' Role in Health Care Legislation Predicted to Increase

Article excerpt

The coming storm in health care legislation should raise the national profile of Oklahoma's Don Nickles.

Once tossed around as a possible presidential candidate, the 49- year-old Republican is one senator Washington analysts expect to see much more of as the 105th Congress settles into its election-year session. According to Associated Press reports, Nickles will be the GOP "answer man" to Democrat proposals hoping to give consumers more protection under the umbrella of managed care reform.

As a Republican health care task force has not been assembled, and formal proposals have yet to emerge, Nickles could end up playing a key role in the formation of Republican strategies -- aimed, like the Democrats, at improving the quality of health care across the nation, though probably with a less-regulatory, more pro-business slant. Whatever happens, Nickles reportedly plans to pack his schedule with more media appearances on health care -- at the request of Senate Majority Leader Trent Lotts. Business As Washington prepares for managed care reform debate, the Oklahoma HMO Association has joined with its counterparts in the nationwide "Putting Patients First" program, in hopes of improving communication with patients and physicians and to streamline administrative procedures. That program's patient-centered policies include: * Health plans will inform members about all aspects of the plan's structure, policies and practices, such as how participating physicians are paid, whether a particular drug is on the plan's formulary and how decisions are made about whether particular treatments are considered experimental. * Health plans will encourage active communication between physicians and patients about medical care and treatment options, even those not covered by the health plan. * Health plans will clearly explain how a patient may appeal coverage or treatment decisions with which they disagree and will expedite appeals in urgent situations. * Health plans will cover emergency care screening and stabilization as needed for conditions that reasonably appeal to be an emergency, based on the patient's presenting conditions. * Health plans will take necessary steps to ensure that physicians are appropriately involved in guiding policies and practices related to quality improvement, utilization management and development of practice guidelines. More than 450,000 Oklahomans are currently served by HMOs. About 136,800 of those are enrolled in the commercial operations and Medicare risk plan of Tulsa-based PacifiCare of Oklahoma, the subsidiary of PacifiCare Health Systems. Tuesday, PacifiCare said its state plans have earned three-year, full accreditation from the National Committee for Quality Assurance, joining the other 160 HMOs nationwide holding such accreditation as of Dec. 31. Like Nickles, CommunityCare has expanded its profile across the globe with the launch of its corporate page on the Internet: www.ccmhp.com Among its features: information on the health maintenance organization and its many different plans and programs, wellness data, provider directories, e-mail boxes for comments and links to Web sites by the owner hospitals -- Mercy Health Center, St. Anthony, St. Francis and St. John Medical Center. Five regional hospitals have received Partners in Quality Improvement Awards from the Oklahoma Foundation for Medical Quality: Seminole Municipal, Southwestern Memorial in Weatherford, Broken Arrow Medical Center, Marshall Memorial in Madill, Harmon County Memorial in Hollis. The first of those winners will receive a new name when its new 32-bed home is completed in April. …

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