North Carolina Senate Approves Patients’ Rights Bill
The North Carolina Senate on April 25 unanimously approved a patients' rights bill that would allow state residents to sue their health plans for denial of care, the Raleigh News & Observer reports. Under the bill, patient grievances would first be examined by the health plan and an external review panel. After the cases matriculated through the internal and external review processes, patients can sue their HMOs in state court. The bill also would:
- Allow patients to receive any medicine prescribed to them by a doctor, even if the drug was not on the HMO formulary;
- Permit people with serious chronic diseases to choose specialists as their primary care physicians;
- Require managed care companies to cover the cost of clinical trials; and
- Create a patients' assistance program that would aid with grievance and appeals procedures.
Opposition Warns of Rising Cost
Managed care companies and business groups have opposed the bill, stating that patient lawsuits will drive up the cost of coverage. Paul Mahoney, executive director of the North Carolina Association of Health Plans, said, "There's the potential for an extremely high cost increase" (AP/Winston-Salem Journal, 4/26). Chris Conover, a public policy analyst at Duke University, said that the legislation will likely cause premiums to rise "anywhere from 1.2% to 7.8%" (Raleigh News & Observer, 4/26). However, Alan Hirsch, an adviser to the governor, said that similar patients' rights laws in Texas and Georgia have not resulted in cost increases (AP/Winston-Salem Journal, 4/25). Although health plans oppose the bill, Blue Cross and Blue Shield of North Carolina, the state's largest health insurer, supports the measure. "Throughout the discussions on this bill, we've said we support giving consumers additional legal protections, provided they are required to go through an internal and external review process first before going to the courts," Bob Greczyn, the company's president and CEO, said (Raleigh News & Observer, 4/26).
