While some of these states already have laws requiring health plans to guarantee the issuance of selected products, states may interpret the law as requiring health plans to guarantee issuance of all products to small groups. Service of HMOs In Massachusetts To Be Assessed By naming a panel to study HMO service, Massachusetts Republican Gov. William F. Weld has temporarily defused a conflict between the state's HMOs and lawmakers who are considering dozens of regulatory bills. Weld told the 15-member commission to report within six months, and he didn't say what he thought of the bills in the hopper.
Some legislators say six months is too long to wait.
One bill with considerable backing would require responses to denial of care within 15 days, and would expand the Health Department's ability to oversee HMOs. The only state where it has moved forward at all is Kansas, where it passed the Senate. In its original form, the bill addresses clinical decision-making, access to personnel and facilities, choice of provider, grievance procedures and quality of care based on clinical outcomes. These provisions are not likely to appeal to health plans. Ensuring enrollee satisfaction and quality of care is simply good business,'' said New Jersey Republican Assemblywoman Barbara Wright, R.N., a sponsor of the legislation.