North Carolina House Moves Toward Final Passage of Patients’ Rights Legislation, Final Vote Expected Today

The North Carolina House on Aug. 22 gave preliminary passage to a managed care reform bill (HB 194) that would set "minimum standards" for coverage provided by health plans and give patients the right to sue their health plans, the Raleigh News & Observer reports. A final vote on the package is expected today. Under the legislation, patients would have the right to sue their insurance company regarding care and coverage decisions after exhausting an appeals process, which would be conducted by an independent review panel (Fisher, Raleigh News & Observer, 8/23). This review process would be "expedited" if a patient's life or health was "in jeopardy." Insurers would also be prohibited from offering "financial inducements" to providers to encourage them to "deny or limit care" under the legislation. Another provision of the bill would create the Office of Managed Care Patient Assistance Program ( AP/Winston Salem-Journal, 8/23). This program would help patients with "questions and problems" regarding their managed care plans and would create the independent review system. State Rep. Phil Baddour (D), who sponsored the bill, said the governor's office, the Department of Insurance and the attorney general's office agreed that the program should work out of the attorney general's office, which "already handles" other consumer issues (Raleigh News & Observer, 8/23). Lawmakers also attached several amendments to the legislation, including measures that would allow patients to patronize any pharmacy, regardless of whether it contracts with the patient's health plan. However, pharmacists would be required to charge copayments as detailed by the consumers' health plans. Another amendment passed with the legislation would delay by two months the date the bill would take effect, to May 1, 2002. After receiving approval on a 114-4 vote, the legislation will return to the House floor for a final vote today (AP/Winston Salem-Journal, 8/23). If the measure passes as expected, it will move to a conference committee to be "reconciled" with a "similar" Senate version of the bill that passed in April (Raleigh News & Observer, 8/23). For further information on state health policy in North Carolina, visit State Health Facts Online.