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WASHINGTON-A group of state legislators, saying states need a proper model for legislation to restrain managed care excesses, last week unveiled a model bill they claimed would protect consumers' rights.
The model bill was developed by a group of Republican and Democrat state legislators under the auspices of Women in Government, a bipartisan non-profit group. Among its provisions, the bill would: guarantee patients their choice of providers so long as they pay an additional fee; allow thepatient to pick a specialist as a primary care doctor; prohibit so-called gag clauses preventing open discussion between a doctor and patient; and compel plans to disclose limits on coverage for experimental treatment and to provide written justification of denials.
The bill was introduced last week in the New Jersey Assembly and will be introduced shortly in Texas, Colorado, Georgia, Delaware, Kansas, Ohio, Oregon and Tennessee.
Separately, New York Gov. George E. Pataki and the leaders of the New York Legislature have agreed to introduce a bill that would allow patients and their doctors, rather than insurers, to decide how long they need to remain in hospital after a mastectomy. The bill also would require insurers to pay for reconstructive surgery after a mastectomy.