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HMO regulation stalls in committee

February 28, 1996
By: Angie Gaddy
State Capital Bureau

JEFFERSON CITY - Not even the most complicated surgery takes two months to cut and stitch.

But the deeper the incision, the longer the time it takes for Missouri's legislatorso cut into the managed health care industry.

After weeks of stalling in both Senate and House committees, bills known as the "Patient Fairness Act," still haven't left legislators' waiting rooms.

As House subcommittee on Health and Welfare met Tuesday to discuss the future of HMO regulation, the only movement was to roll two bills into one and postpone any movement until further review.

"I will just be trying to orchestrate the bill so it will be passable out of committee," said the committee's chair, Rep. Mary Bland, D-Kansas City. "Whether it will be or not, I don't know."

The measures would require health maintenance organizations (HMOs) to disclose information to enrollees and keep doctors from being dropped mid plan.

The bill's sponsor, Rep. Craig Hosmer, D-Springfield said he would work with both HMOs and doctors to draft an agreement.

"But we don't want to sacrifice the quality," he said.

But both representatives of sides in this dispute - the medical community and the insurance industry - say it's nearly impossible for them to agree on the future of patients' health care.

"Everyday they can put it off is a victory for them," said Tom Holloway, lobbyist for Missouri Medical Association, "Now, they just bought another week."

The health insurance industry claims the measures would increase health care costs.

"It has a very destructive effect on the cost of health care," said Gary Maineschein, lobbyist for Blue Cross/Blue Shield of Missouri.

Disclosing information to enrollees means they wouldn't be able to competitively bid for contracts. That's what keeps the price of health care down, he said.

In the meantime, as the medical community and the insurance industry continue their bickering, Bland says lawmakers should focus on the important issue - the patient.

"The bottom line is the care of the patient," she said. "It's our responsibility to make sure people are taken care of."