MANAGED CARE PLANS TARGETED

WASHINGTON-Two bills introduced in the House and Senate last week would take aim at several managed care practices as well as open up new avenues to sue plans.

Provisions in the measures, introduced by Sen. Alfonse D'Amato, R-N.Y., and Rep. Charles Norwood, R-Ga., would guarantee patient access to emergency care without prior approval from a managed care plan.

Other provisions would prohibit so-called gag rules under which some plans have restricted health care professionals from discussing with patients alternative treatment options or financial incentives to limit care.

The measures also would allow enrollees in self-insured managed care plans to sue the plans for malpractice under state law rather than under the federal Employee Retirement Income Security Act. That would expose the plans to punitive damage awards, which are barred under ERISA.