HMO reform law celebrated in re-enactment of signing

Art Nadler

Thursday, July 24, 1997 | 9:13 a.m.

Representatives from 46 groups that lobbied the Legislature to pass sweeping managed care reform took pride in watching Gov. Bob Miller re-enact signing Assembly Bill 156.

"I was thrilled to see its passage," Barbara Buckley, D-Las Vegas, said at Wednesday's ceremony in Las Vegas. "It's one of the most comprehensive laws in the country. We are usually No. 1 in lung cancer and heart statistics. It's nice to be on the top of the ranking in states for patient protection."

AB156, which was sponsored by Buckley, changed the way health maintenance organizations (HMOs) do business in that it:

* Toughens the standards for denying care that is covered.

* Prohibits insurance companies from deciding what doctors can say to patients.

* Prohibits insurance companies from terminating doctors' contracts for encouraging patients to report violations to authorities.

* Outlaws payment incentives to doctors who deny medical care to patients.

* Requires emergency room care to be covered if the patient and doctor feel that it is an emergency.

* Requires that medical directors of insurance companies be licensed Nevada doctors.

* Requires that each insurance company set up a grievance board and that complaints be resolved in 30 days.

* Requires that complaints regarding emergency care be resolved in 72 hours.

* Requires reporting of all complaints and their resolution.

* Requires insurance companies to advise each person of the right to file a complaint when care is denied.

Buckley presented a plaque to the president of the Nevada Health Care Reform Project, an organization of 540,000 Nevadans that lobbied the Legislature for AB156's passage. It consists of consumers, health care professionals, labor organizations and 26 physically disabled groups.

"This project has been going on for four years," Ruth Mills, president of NHCRP, said. "It was exciting working on this, and the timing had a lot to do with it."

Mills added that NHCRP's health care reform movement isn't over. The organization hopes to win support in the 1999 Legislature for universal health care for the state's 400,000 uninsured individuals.

For information on this project, Mills suggests contacting the League of Women Voters of the Las Vegas Valley at 631-4998.