Extra benefit to consumer rights law

Art Nadler

Thursday, Jan. 29, 1998 | 10:14 a.m.

President Clinton's call for Congress to enact a federal Consumer Bill of Rights law to protect patients insured by managed-care plans would also benefit thousands of Medicare recipients and self-insured individuals in the state.

According to recent Health Care Financing Administration statistics, there were 202,213 Medicare beneficiaries living in Nevada in 1996. Additionally, HCFA identified 443,069 people enrolled in various self-insured programs.

People enrolled in these two programs are not protected by the same laws that oversee how health maintenance organizations (HMOs) operate within the state.

The president's request in his State of the Union speech Tuesday night urged Congress to pass a law that would give not only these patients but everyone the right to know all medical options before making decisions, the options to choose doctors of their choice, have access to emergency room care when deemed necessary and to maintain confidentiality of medical records.

"I think in terms of patient protection act issues, he (Clinton) is on the right track," said Larry Matheis, executive director of the Nevada State Medical Association. "The same public ground swell we saw last year would become true nationwide (for federal programs)."

The Legislature, through passage of Assembly Bill 156, enacted some of the strongest consumer health care safeguards in the nation last January. The bill, in part, mirrored what Clinton is asking for nationwide.

AB156 toughens the standards for denying care, prohibits insurance companies from deciding what doctors can say to patients, outlaws doctor payment incentives for denying medical services and requires emergency care if the patient and doctor feel it is an emergency.

"In my opinion, we need to do more work so patients know what their options are," Sen. Harry Reid, D-Nev., said Wednesday in support of the president's request. "Nothing covers the federal programs now."

Rep. John Ensign, R-Nev., agreed with the president in giving people the freedom to choose their physicians, but he felt one of Clinton's proposals under the Consumer Bill of Rights would increase insurance premiums 20 percent.

"We (Congress) will enact some sort of bill to put consumer protection in there," Ensign said.

Clinton also urged Congress to pass legislation that would give people between the ages of 55 and 65 an option to buy into Medicare for around $300 a month.

Reid said this would reduce the number of people seeking treatment in emergency rooms and billing the public as indigent care.

Ensign said he favored medical savings accounts instead. With MSAs, taxpayers would put money for medical emergencies into special savings accounts.

"Not all HMOs are alike," said Ria Marie Carlson, vice president of public relations and communications with Sierra Health Services Inc., Nevada's largest managed care organization. "In general terms, we agree with the president. We don't prohibit doctors from discussing alternatives. We support confidentiality."