February 2001 Bulletin

In Brief

This will be a pivotal year for state legislatures, says the National Conference of State Legislatures (NCSL).

Term limits resulted in significant membership turnover. In 44 states that held elections in 2000, nearly 23 percent of the seats up for election brought new members to those legislatures. An estimated 1,300 new legislators will be sworn in this year and at least 30 state House speakers or state Senate presidents will be new this year.

The NCSL believes key issues in the new legislative sessions include election reforms, simplified state sales tax system, prescription drug costs, growth management and redistricting. Scope of practice is expected to be a hot issue in many states, as it has been in the past.

Before the election, Democrats controlled 19 legislatures, Republicans controlled 17 and 13 legislatures were split. After the election, the Republicans controlled 17 legislatures, Democrats controlled 16 and 16 had split control.

Democrats control legislatures in Alabama, Arkansas, California, Connecticut, Georgia, Hawaii, Louisiana, Massachusetts, Maryland, Mississippi, North Carolina, New Mexico, Oklahoma, Rhode Island, Tennessee and West Virginia. Republicans control legislatures in Alaska, Florida, Iowa, Idaho, Kansas, Michigan, Montana, North Dakota, New Hampshire, New Jersey, Ohio, Oregon, Pennsylvania, South Dakota, Utah, Virginia and Wyoming.


Michigan Gov. John Engler vetoed legislation that would have required timely payment of health care claims by all health insurers. The bills would have required all health care claims to be paid within 45 days, with late payment of claims bearing 12 percent interest. Exceptions would have been made for claims submitted with incomplete or inaccurate information. Last year 12 state legislatures, including Michigan, approved prompt payment laws. The states are Arizona, California, Florida, Kansas, Kentucky, Massachusetts, Minnesota, New Hampshire, North Carolina, New Mexico and Tennessee.


Delaware Gov. Ruth Ann Minner unveiled a patients’ bill of rights that would allow patients who are dissatisfied with their health plans to appeal to an arbitrator or an independent review panel. The legislation also would give patients emergency room care without preapproval of their physicians, access to prescription drugs that are not on their HMO’s approval list and the right to see specialists without referrals from primary care physicians. It was her first major legislation since she was elected in November. Patient protection laws that provide external review were approved last year by legislatures in Arkansas, Delaware, Massachusetts, Maine, Michigan, New Hampshire, South Carolina, Virginia, Washington and Wisconsin.


Although the majority of California’s largest HMOs require patients to submit disputes to an arbitrator, many are not reporting the cases as required by law to the state, according to a report by the California Research Bureau, an arm of the State Library that conducts studies for lawmakers. The report estimated that about 300 medical cases are decided in California each year, but only 171 were reported to the Department of Managed Health Care from March 1999 to April 2000. "Since 30 (of California’s main 50 health plans) require binding arbitration, it seems likely that many health plans are not complying with the statutory reporting requirement," the report said. The California Association of Health Plans disputed the report’s estimate of 300 annual cases, and said most cases are resolved through the HMOs’ grievance process with their patients.

New Jersey

The New Jersey Senate passed a $147 million package of 20 health care reform bills, including legislation that would give doctors more bargaining power in negotiations with managed care companies. Also, state residents would be allowed to sue their HMOs for denying or delaying care.

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