As Congress debates HMOs, many Nevadans are protected

Friday, July 16, 1999 | 10:28 a.m.

The 1997 Nevada Legislature adopted its own patient bill of rights for participants in managed care plans, including mandated care for emergencies, an appeals process for denial of care, and the requirement that medical professionals, not clerks, make decisions on care.

Assemblywoman Barbara Buckley, D-Las Vegas, the architect of the measure, says it has been working well, with fewer complaints about conduct by health maintenance organizations and other types of managed care providers.

"Our bill helped tremendously," she said. "It ensured that a number of very basic concerns were addressed."

But complaints haven't stopped altogether. And concern about HMO noncompliance with the law led Buckley to successfully push in the 1999 session for a cabinet-level office staffed by medical professionals for people to turn to with questions and complaints.

Gov. Kenny Guinn in June signed into law the measure creating the Office for Consumer Health Assistance. That office has yet to be set up.

Even with Nevada leading the way on the patients' rights issue, Buckley said the national legislation is vital to many Nevadans with health insurance. The state can't legislate health care coverage for many types of health care plans, including self-funded plans, government plans and others.

Earlier this week, the Senate rejected a proposal to require HMOs to allow women to use an obstetrician-gynecologist as a primary physician. Another proposal to require HMOs to provide specialists outside their network of medical professionals also was defeated, along with a plan to let patients sue HMOs in state courts.

A proposal to allow overnight hospital stays for breast cancer patients was approved.

The Nevada Legislature in 1999 mandated that insurance companies allow women to use an obstetrician-gynecologist as a primary care physician, and mandated that companies pay for contraceptives.

Buckley said Senate Republicans' refusal to allow women to have direct access to their gynecologist or obstetrician shows that they are out of touch with their constituents.

"They should talk to their wives, their girlfriends or their daughters," she said. "This is not a radical proposal."