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HMO Regulation

October 28, 1996
By: David Freitas
State Capital Bureau

Gag orders on doctors would be banned under a tentative proposal from a state legislative committee that has been studying managed care.

Dave Freitas has the story from Jefferson City.

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The gag-order ban is one of 20 different tentative recommendations before the committee.

The ban would prohibit an HMO from restricting what a doctor would tell his patient.

Some witnesses before the committee charged HMOs have banned doctors from discussing treatments not covered by the health-care plan.

The committee tentatively suggested stronger state regulation of managed care contracts... including approval of plans before they can even go on the market.

Legislators meet Wednesday with members of the health care industry to discuss the suggestions.

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A group of Missouri legislators are calling for stronger state regulation of HMO's:

David Freitas has the story from Jefferson City.

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After hearing days of testimony, a joint legislative committee has issued a set of 20 tentative reccommendations.

One of the strongest recommendation would require that the approval of any managed care plan by the State Insurance Department before it could be marketed.

Other recommendations include banning HMOs from imposing gag orders on doctors discussing alternative treatments with their patients.

The committee also suggests requiring an HMO to cover care for obvious emergencies -- without first getting approval from the HMO.

These tentative recommendations are far from final. They'll face committee review this Wednesday.

And whatever comes out of that committee will go before the full legisalture when it meets in January.

David Freitas reporting from the Capital.