MDN.ORG:
Missouri Digital News
MDN.ORG
Mo. Digital News
Missouri Digital News
MDN.ORG:
Mo. Digital News
MDN.ORG:
Missouri Digital News
MDN.ORG:
Missouri Digital News
MDN.ORG
Mo. Digital News
Missouri Digital News
MDN.ORG:
Mo. Digital News
MDN.ORG:
Missouri Digital News
DATE: Feb. 11, 1997
JEFFERSON CITY - A Columbia doctor told a Senate committee Tuesday how he had to fight with a managed care organization to keep a heart patient awaiting surgery overnight in the hospital.
Cardiologist Jerry Kennett spoke to the Senate Aging, Families and Mental Health Committee Tuesday during the committee's hearing on managed health care regulation.
Kennett shared his frustrations over many managed care providers' "pre-authorization" requirements, by which physicians must contact a representative, via telephone, to determine whether the company will pay for a medical procedure.
"I found out the person was an arthritis specialist ... in Ohio," Kennett said about the person he talked to who initially denied payment for a one-night hospital stay.
Kennett was joined by a slew of people who testified for and against the bill that would set statewide standards for managed care operation.
The Senate bill and its House twin were drafted by a joint committee that met during the legislative intersession to research the need for managed care regulation in Missouri.
"We ran across things that we consider absolutely appalling," Senate Sponsor Joe Maxwell said of the joint committee's findings on the need for regulation.
Maxwell, D-Mexico, cited gag clauses, which prohibit doctors with some health maintenance organizations from giving patients certain information, as one of the "appalling" findings.
"Don't think we're trying to run (managed care) out of the state," said Sen. Morris Westfall, R-Halfway, a member of both the Senate and joint committees.
Westfall said he thinks the managed care industry just needs a set of standards.
However, opponents say the bill goes too far.
"We want to make sure we're not regulated into a situation where we cannot survive," said Kevin McRoberts, a representative of Missouri Advantage, a local HMO.
Howard said he predicts the committee will pass a revised version of the bill based on the concerns of both sides of the issue.
"There is a consensus out here that we need a substitute bill," Howard said.
Maxwell said he has spoken with Gov. Mel Carnahan and his deputy chief of staff recently and is actively seeking Carnahan's full support on the bill.
"He has personally told me he is very open to (compromise)," Maxwell said.