LAWMAKERS WANT INPUT ON MANAGED HEALTH CARE

Missouri legislators want to learn more about managed health-care options, availability and quality.

The newly formed Joint Interim Committee on Managed Care will conduct a series of public hearings in Jefferson City starting Aug. 12, to gather comments and data from employers, insurance companies and consumers about managed health-care plans.

Committee co-chairman Sen. Joe Maxwell, D-Mexico, said about 3,000 notices have been sent to health-care providers, insurance companies, health-care associations and concerned people.

Maxwell said the committee was formed after legislative leaders "made note of the large number of bills filed in regard to managed care" last session. "They felt that a hodgepodge of legislation was not the way to address the issues."

Committee members hope to be able to identify issues and areas of concern in managed care, said Sen. Jerry Howard, D-Dexter.

"We know already that accessibility is a problem in our part of the country," Howard said, pointing out that managed care has made little headway in the Southeast Missouri health-care market.

Howard said one of his concerns is "retroactive diagnoses," in which a patient finds he or she is not covered for what an insurance company deems a pre-existing condition. The committee also will look at the role of gatekeepers in the managed-care system, he said.

He said committee members hope to find out what types of care people want covered through managed-care plans.

"I think we'll find out there are people out there who have mental health needs who feel like those needs are not being addressed on a parity basis with physical health needs," Howard said.

He said the committee also will begin to get feedback on MC-Plus, the new managed-care organ for Medicaid; look at how many physicians have contracted with managed-care organizations and which organizations they have joined; and whether they are forming their own organizations.

In light of the number of bills introduced last session about managed care, the hearings may result in new legislation, Maxwell said.

"The real question is whether or not there needs to be a real serious attempt to legislate change," he said. "That's the part that I'm not certain of. I'm not going to go into this process with the notion that legislation is necessary. A lot of the issues surrounding managed care may or not be the state's role; some of those issues are being looked at at the federal level."

Anyone wishing to testify at the hearings, which will be held Aug. 12-16 at the State Capitol Building, should call 1-800-582-2196 for an appointment.

Also serving on the committee are Rep. Tim Harlan, D-Columbia, co-chairman; Sens. Betty Sims, R-St. Louis, Morris Westfall, R-Halfway, and Harry Wiggins, D-Kansas City; and Reps. Mary Groves-Bland, D-Kansas City, James Foley, D-St. Ann, John Griesenheimer, R-Washington and Charles Pryor, R-Versailles.