North Carolina Governor Signs Patients’ Rights Bill

North Carolina Gov. Mike Easley (D) on Oct. 18 signed into law a patients' rights bill that includes a provision allowing patients to sue their managed care plans, the Raleigh News & Observer reports (Rawlins/Bonner, Raleigh News & Observer, 10/19). Passed last week by the state House and state Senate, the "sweeping" legislation (S 199) also would:

Allow patients with chronic conditions to designate specialists as primary care doctors.
Establish a process by which patients can appeal a health plan's medical decision to an independent panel after two internal reviews. After the external review process, patients can sue health plans in state court.
Create a state-managed care assistance program to help patients navigate the appeals process.
Permit patients who are being treated for chronic conditions and whose doctor has been dropped from a health plan's network to continue treatment with that doctor for up to 90 days.
Prohibit insurers from giving doctors financial incentives to deny or limit care.
Permit parents to select a pediatrician as a primary care provider for children (Kaiser Daily Health Policy Report, 10/10).

To assist patients in navigating the appeals process, the state will launch the Managed Care Patient Assistance Program, although the office will also serve as a "catchall" for any questions or problems individuals may have with their managed care plans. About 5.1 million North Carolina residents have employer-sponsored health insurance, but about 40 to 50% of these employees are enrolled in health plans regulated by ERISA, which are exempt from state mandates. However, the new law will apply to state government workers. "Too often, managed care companies seem to place more emphasis on 'managed' and less emphasis on 'care,'" Easley said, adding, "This bill guarantees that no one gets between you and your doctor. This legislation puts the focus back on care and puts the medical decisions back in the hands of doctors" (Raleigh News & Observer, 10/19). For further information on state health policy in North Carolina, visit State Health Facts Online. This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

North Carolina Governor Signs Patients’ Rights Bill

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