The following article appeared in the Helena Independent Record.
IR State Bureau
HELENA - Rep. Bruce Simon, R-Billings, wants lawmakers to review controversial new rules recently approved by the state that will govern managed-care in Montana approved by the state. (sic)
The 1997 Legislature passed the Managed-Care Adequacy and Quality Control Act, but it doesn't take effect until Oct. 1 because insurers, health care advocates, medical providers and the state had to hammer out the details. Though a the (sic) final version of the rules was recently adopted by the state, Simon argues many of the most controversial issues remain unresolved.
"I'm not trying to specifically argue my case," said
Simon, who is running for state auditor, who is the state's insurance
commissioner. "Before we implement them, it's only appropriate
and proper to have another legislative hearing so we can take
another look."
But time is running short. The rules will take effect Oct. 1,
unless the Legislature's interim Children, Families, Health and
Human Services Committee votes to have another public hearing.
Five of the eight committee members would have to vote for the
hearing, said Simon, who is not on the panel.
Chairwoman Sen. Mignon Waterman, D-Helena, wasn't available for comment Wednesday.
The most contentious provision allows a health network to still offer its plan to insurance consumers even if it fails to negotiate a contract with local providers such as a hospital. As long as the health network makes a "good faith" effort, it can still offer the plan in that community even though no local providers are participating.
Some opponents, such as state Auditor Mark O'Keefe, said the definition of "good faith" is unclear and Montanans may be forced to travel further for medical services or health networks may be allowed to reimburse patients for a smaller amount of their bill.
Updated: Tuesday, October 5, 1999.
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